Provider Demographics
NPI:1376200931
Name:TAMEZ, MARCUS EDWARD (DC, MSFN, BA, BS, BS)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:EDWARD
Last Name:TAMEZ
Suffix:
Gender:M
Credentials:DC, MSFN, BA, BS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 JUSTIN RD.
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087
Mailing Address - Country:US
Mailing Address - Phone:469-314-1885
Mailing Address - Fax:
Practice Address - Street 1:685 JUSTIN RD.
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087
Practice Address - Country:US
Practice Address - Phone:469-314-1885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor