Provider Demographics
NPI:1063038990
Name:MARIN, LUIS ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ENRIQUE
Last Name:MARIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 VIN RALIUGA CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2392
Mailing Address - Country:US
Mailing Address - Phone:915-400-5871
Mailing Address - Fax:915-856-2458
Practice Address - Street 1:320 VIN RALIUGA CT
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-2392
Practice Address - Country:US
Practice Address - Phone:915-400-5871
Practice Address - Fax:915-856-2458
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6011208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics