Individual
MARC E. DELCLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
J4079
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117949102
—
TX
01
—
82M941
BCBS
TX
01
—
920003064
RR MEDICARE
TX
Enumeration date
08/22/2006
Last updated
09/29/2021
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