Individual
DR. THAO TRAN MARQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD,MS
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 7011B, CREVE COEUR, MO 63141-8232
(314) 251-6840
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2018-0703
NM
208C00000X
Colon & Rectal Surgery Physician
2012029320
MO
208D00000X
General Practice Physician
48381
MN
Other
Enumeration date
12/18/2006
Last updated
08/06/2018
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