Provider Demographics
NPI:1073803334
Name:ARAGON, MARKO OBED (CST)
Entity Type:Individual
Prefix:MR
First Name:MARKO
Middle Name:OBED
Last Name:ARAGON
Suffix:
Gender:M
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 KING WILLIAM DR
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-4516
Mailing Address - Country:US
Mailing Address - Phone:713-906-6103
Mailing Address - Fax:
Practice Address - Street 1:104 KING WILLIAM DR
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-4516
Practice Address - Country:US
Practice Address - Phone:713-906-6103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103934246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist