Provider Demographics
NPI:1174871339
Name:MARABOTO, EDUARDO ALBERTO (ACNS-BC)
Entity type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:ALBERTO
Last Name:MARABOTO
Suffix:
Gender:M
Credentials:ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 STECK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-8060
Mailing Address - Country:US
Mailing Address - Phone:512-476-3556
Mailing Address - Fax:512-476-0195
Practice Address - Street 1:3215 STECK AVE STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-8060
Practice Address - Country:US
Practice Address - Phone:512-476-3556
Practice Address - Fax:512-476-0195
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX791490364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health