Provider Demographics
NPI:1164772323
Name:MEDINA-ZEA, MARCO VINICIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:VINICIO
Last Name:MEDINA-ZEA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6210 E HIGHWAY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9596
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:1401 MEDICAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5026
Practice Address - Country:US
Practice Address - Phone:512-260-1581
Practice Address - Fax:512-406-7309
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2021-09-01
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-10315208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery