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Individual

DIEGO C MARINES COPADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
18220 TOMBALL PKWY, SUITE 280, HOUSTON, TX 77070-4347
(281) 737-8465
Mailing address
18220 TOMBALL PKWY, SUITE 280, HOUSTON, TX 77070-4347
(281) 737-8465

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
Q4802
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10035355
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
350607301
TX
05
350607302
TX
01
8FG094
BLUE CROSS BLUE SHIELD
TX
01
8GD704
BCBS
TX
Enumeration date
06/16/2009
Last updated
12/19/2016
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