Provider Demographics
NPI:1679694269
Name:HAGGARD, MARCUS D (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:D
Last Name:HAGGARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-338-9032
Mailing Address - Fax:281-338-9039
Practice Address - Street 1:1015 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 1600
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:281-338-9032
Practice Address - Fax:281-338-9039
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice