Provider Demographics
NPI:1316006554
Name:MARVIN, ROBERT GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGE
Last Name:MARVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3429 W HOLCOMBE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1311
Mailing Address - Country:US
Mailing Address - Phone:713-993-7124
Mailing Address - Fax:713-963-0476
Practice Address - Street 1:3429 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1311
Practice Address - Country:US
Practice Address - Phone:713-993-7124
Practice Address - Fax:713-963-0476
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7071208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137749112Medicaid
TX00897TMedicare ID - Type Unspecified
TXF88213Medicare UPIN