Provider Demographics
NPI:1104188234
Name:BISHAI, MARINA G (DO)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:G
Last Name:BISHAI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 BATES AVE # FC1860
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2698
Mailing Address - Country:US
Mailing Address - Phone:832-824-5447
Mailing Address - Fax:
Practice Address - Street 1:18200 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1285
Practice Address - Country:US
Practice Address - Phone:832-227-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13205208000000X, 208M00000X
TXU0305208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist