Provider Demographics
NPI:1891942496
Name:MARCELO TOTORICA MD PA
Entity Type:Organization
Organization Name:MARCELO TOTORICA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTORICA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-451-3030
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-0128
Mailing Address - Country:US
Mailing Address - Phone:281-833-3330
Mailing Address - Fax:281-833-3323
Practice Address - Street 1:1910 JOHN RALSTON RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77013-5697
Practice Address - Country:US
Practice Address - Phone:713-451-3030
Practice Address - Fax:713-451-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7229207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0012RWGOtherBCBS OF TEXAS GROUP PROVIDER ID
TX00Z746OtherMEDICARE GROUP PTAN
TX198085601OtherMEDICAID GROUP TPI