Individual
MARLENE CERECERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 W ILLINOIS AVE, MIDLAND, TX 79701-6158
(432) 262-3822
Mailing address
3910 TANNER DR, MIDLAND, TX 79703-6143
(432) 270-2373
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA13915
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2019
Last updated
01/04/2021
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