Individual
ISSAM MARZOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4305 N MESA ST, SUITE A, EL PASO, TX 79902-1123
(915) 532-2477
(915) 532-2470
Mailing address
4305 N MESA ST STE A, EL PASO, TX 79902-1124
(915) 532-2477
(915) 532-2470
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
Q6345
TX
207RP1001X
Pulmonary Disease Physician
Q6345
TX
390200000X
Student in an Organized Health Care Education/Training Program
RS2014-0452
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355967601
—
TX
Enumeration date
07/21/2009
Last updated
07/21/2022
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