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Individual

MARCELO SANDOVAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.,

Contact information

Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, APT. 1A, HOUSTON, TX 77210-4439
(713) 792-2991

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
174121
NY
207P00000X
Emergency Medicine Physician
Primary
P3973
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01351748
NY
05
306788601 (MDACC)
TX
01
8DL810
BCBS (MDACC)
TX
Enumeration date
10/11/2006
Last updated
12/19/2012
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