Provider Demographics
NPI:1457616534
Name:YOLANDA MARCOS MD PA
Entity Type:Organization
Organization Name:YOLANDA MARCOS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-494-4290
Mailing Address - Street 1:510 MED COURT
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3484
Mailing Address - Country:US
Mailing Address - Phone:210-494-4290
Mailing Address - Fax:210-494-4809
Practice Address - Street 1:510 MED CT STE 210
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3484
Practice Address - Country:US
Practice Address - Phone:210-494-4290
Practice Address - Fax:210-494-4809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB157622Medicare PIN