Provider Demographics
NPI:1396916326
Name:PARGA, MARCOS ALFREDO (MPT)
Entity type:Individual
Prefix:
First Name:MARCOS
Middle Name:ALFREDO
Last Name:PARGA
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1421 N LEE TREVINO DR
Mailing Address - Street 2:SUITE B2A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6463
Mailing Address - Country:US
Mailing Address - Phone:915-591-0243
Mailing Address - Fax:915-591-0256
Practice Address - Street 1:1421 N LEE TREVINO DR
Practice Address - Street 2:SUITE B2A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6463
Practice Address - Country:US
Practice Address - Phone:915-591-0243
Practice Address - Fax:915-591-0256
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1179939OtherPHYSICAL THERAPY LIC #