Organization
TODD A. MARAIST, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD A MARAIST MD (OWNER)
(979) 846-4100
Entity
Organization
Contact information
Practice address
1105 UNIVERSITY DR E STE 100, COLLEGE STATION, TX 77840-2183
(979) 846-4100
(979) 846-4118
Mailing address
1105 UNIVERSITY DR E STE 100, COLLEGE STATION, TX 77840-2183
(979) 846-4100
(979) 846-4118
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
H6405
TX
208VP0000X
Pain Medicine Physician
09505
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N38V
BCBS
TX
Enumeration date
01/22/2008
Last updated
01/22/2008
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