Individual
MARIELA D VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1201 W FRANK, MEMORIAL MEDICAL CENTER, LUFKIN, TX 75904
(936) 639-7557
Mailing address
PO DRAWER 1906, 821 W FRANK, LUFKIN, TX 75902-1906
(936) 639-5474
(936) 639-5487
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
J6787
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8661B0
BCBS
—
Enumeration date
09/25/2006
Last updated
07/08/2007
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