Provider Demographics
NPI:1548379258
Name:MARRERO, CHRISTOPHER EARL (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EARL
Last Name:MARRERO
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 1:2400 HIGHWAY 365 STE 207
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6250
Mailing Address - Country:US
Mailing Address - Phone:409-724-7407
Mailing Address - Fax:409-724-7479
Practice Address - Street 1:2400 HIGHWAY 365 STE 207
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6250
Practice Address - Country:US
Practice Address - Phone:409-724-7407
Practice Address - Fax:409-724-7479
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4323207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAG74425Medicare UPIN