Provider Demographics
NPI:1205317088
Name:MARQUEZ, IRMA VERONICA (OTR)
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:VERONICA
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6393 LOS ROBLES DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2951
Mailing Address - Country:US
Mailing Address - Phone:915-355-9361
Mailing Address - Fax:
Practice Address - Street 1:11169 SEAN HAGGERTY DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79934-3385
Practice Address - Country:US
Practice Address - Phone:915-849-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108546225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist