Organization
CHILDRENS CRITICAL CARE OF SAN ANTONIO PA
Active
Organization
CHILDRENS CRITICAL CARE OF SAN ANTONIO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W MARCUM MD (PRESIDENT)
(210) 785-8282
Entity
Organization
Contact information
Practice address
5925 KIRBY DR, E354, HOUSTON, TX 77005-2546
(210) 785-8282
(210) 785-8288
Mailing address
5925 KIRBY DR, E354, HOUSTON, TX 77005-2546
(210) 785-8282
(210) 785-8288
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
M3009
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014NH
BCBS
TX
05
—
178280701
—
TX
Enumeration date
12/01/2006
Last updated
10/16/2009
Update your record
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