Provider Demographics
NPI:1538504113
Name:MARQUETTE, CAROL HEDWIG (PA)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:HEDWIG
Last Name:MARQUETTE
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:1440 GEORGE DIETER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7601
Mailing Address - Country:US
Mailing Address - Phone:915-591-4444
Mailing Address - Fax:915-921-9000
Practice Address - Street 1:1440 GEORGE DIETER DR
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7601
Practice Address - Country:US
Practice Address - Phone:915-591-4444
Practice Address - Fax:915-921-9000
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA00620363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant