Provider Demographics
NPI:1326819855
Name:BOJORQUEZ, MARCO T
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:T
Last Name:BOJORQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 BELLAIRE BLVD STE C2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4957
Mailing Address - Country:US
Mailing Address - Phone:346-227-8148
Mailing Address - Fax:
Practice Address - Street 1:7710 BELLAIRE BLVD STE C2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4957
Practice Address - Country:US
Practice Address - Phone:346-227-8148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician