Individual
MARCO ANDRE B RODRIGUES MARICEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Q7073
TX
208600000X
Surgery Physician
Q7073
TX
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
Q70773
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363126901
—
TX
Enumeration date
06/08/2007
Last updated
04/06/2022
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