Provider Demographics
NPI:1821482886
Name:OQUENDO RINCON, MARCIAL ANDRES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCIAL
Middle Name:ANDRES
Last Name:OQUENDO RINCON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18220 MIDWAY RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-4901
Mailing Address - Country:US
Mailing Address - Phone:469-501-1006
Mailing Address - Fax:972-913-4303
Practice Address - Street 1:18220 MIDWAY RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-4901
Practice Address - Country:US
Practice Address - Phone:469-501-1006
Practice Address - Fax:972-913-4303
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8590208D00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice