Individual
MARCO E. BOSQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16020 PARK VALLEY DR, ROUND ROCK, TX 78681-3573
(512) 244-0766
(512) 244-1013
Mailing address
16020 PARK VALLEY DR, ROUND ROCK, TX 78681-3573
(512) 244-0766
(512) 498-1013
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
L1530
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150545502
—
TX
Enumeration date
08/16/2006
Last updated
11/18/2016
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