Provider Demographics
NPI:1851665806
Name:MARX, VIRGINIA (NP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:MARX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 CULLEN BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3922
Mailing Address - Country:US
Mailing Address - Phone:281-412-6262
Mailing Address - Fax:281-412-6740
Practice Address - Street 1:ADVANCED DERMATOLOGY
Practice Address - Street 2:430 S MASON RD SUITE 101
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450
Practice Address - Country:US
Practice Address - Phone:281-665-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX815634163W00000X
TXAP141310363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse