Individual
MR. MARCELO VAILATI VAILATI NEGRAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, UNIT 432, HOUSTON, TX 77030
(713) 792-6161
(713) 792-1220
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-6161
(713) 792-1220
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
46778
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403686501
—
TX
01
—
403686502
CSHCN
TX
Enumeration date
05/22/2017
Last updated
01/14/2020
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