Individual
ANGELA C MARCACCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1051 HALSEY ST, HOUSTON, TX 77015-4959
(713) 453-2972
(713) 450-3609
Mailing address
9006 CLIFFWOOD DR, HOUSTON, TX 77096-3507
(713) 729-2030
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3069
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1122897-08
—
TX
01
—
11616012
CAQH
TX
05
—
1548216-01
—
TX
Enumeration date
03/02/2006
Last updated
07/19/2021
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