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Organization

CHARLES D. DEMARQUE, MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES D. DEMARQUE (MEDICAL DIRECTOR)
(817) 308-8477
Entity
Organization

Contact information

Practice address
4020 N MACARTHUR BLVD, SUITE 122-286, IRVING, TX 75038-6419
(817) 308-8477
Mailing address
4020 N MACARTHUR BLVD, SUITE 122-286, IRVING, TX 75038-6419

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
J1969
TX

Other

Enumeration date
07/24/2013
Last updated
07/24/2013
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