Provider Demographics
NPI:1326518127
Name:SUAREZ, MARCELO OLEGARIO (NP)
Entity Type:Individual
Prefix:
First Name:MARCELO
Middle Name:OLEGARIO
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 W SAM HOUSTON BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5198
Mailing Address - Country:US
Mailing Address - Phone:956-783-1400
Mailing Address - Fax:
Practice Address - Street 1:1002 W SAM HOUSTON BLVD STE 4
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5198
Practice Address - Country:US
Practice Address - Phone:956-783-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139397363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner