Provider Demographics
NPI:1508958547
Name:LIMSIACO, MARCIANO SALVIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCIANO
Middle Name:SALVIO
Last Name:LIMSIACO
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 1:1212 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4616
Mailing Address - Country:US
Mailing Address - Phone:936-295-6939
Mailing Address - Fax:936-295-6939
Practice Address - Street 1:1212 12TH ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4616
Practice Address - Country:US
Practice Address - Phone:936-295-6939
Practice Address - Fax:936-295-6939
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH53382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00H73ZMedicare ID - Type Unspecified