Individual
MARCOS ROSAURO HERMOSO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2411 FOUNTAIN VIEW DR, SUITE 200, HOUSTON, TX 77057-4817
(713) 458-4185
Mailing address
PO BOX 840853, DALLAS, TX 75284-4832
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
K0821
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050056901
RAILROAD - MEDICARE
TX
05
—
122183002
—
TX
01
—
1375012
LA - MEDICAID
LA
01
—
8016J2
OUT HARRIS - MEDICARE
TX
01
—
81316K
IN HARRIS - MEDICARE
TX
01
—
81316K
TX-BLUE SHIELD
—
Enumeration date
01/10/2007
Last updated
12/03/2021
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