Provider Demographics
NPI:1134102643
Name:LERNER, MARVIN W (MD)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:W
Last Name:LERNER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:9494 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1419
Mailing Address - Country:US
Mailing Address - Phone:281-649-7000
Mailing Address - Fax:713-484-6649
Practice Address - Street 1:7789 SOUTHWEST FWY
Practice Address - Street 2:SUITE 470
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1829
Practice Address - Country:US
Practice Address - Phone:281-649-7000
Practice Address - Fax:178-995-4720
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2016-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD0945207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1169583202Medicaid
TXC18336Medicare UPIN
TXC18336Medicare UPIN