Doctor Name: | DR. THAO TRAN MARQUEZ |
NPI Number: | 1275696866 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD,MS |
License Number: | 48381 |
Business Practice Address: | 621 S New Ballas Rd Suite 7011b Creve Coeur, MO - 631418232 |
Business Phone Number: | 3142516840 |
Business Fax Number: | |
Mailing Address: | 11703 Tarrytown Dr, CREVE COEUR |
State: | MO |
Postal Code: | 631418211 |
Phone Number: | 6124239217 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2006 |
NPI Last Update Date: | 09/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 48381 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |