Provider Demographics
NPI:1518776194
Name:MARCANO, MARINELLYS SR (SURGICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:MARINELLYS
Middle Name:
Last Name:MARCANO
Suffix:SR
Gender:F
Credentials:SURGICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10914 BARKER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2348
Mailing Address - Country:US
Mailing Address - Phone:281-406-7049
Mailing Address - Fax:
Practice Address - Street 1:6544 GREATWOOD PKWY STE A
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6808
Practice Address - Country:US
Practice Address - Phone:832-277-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23-648246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant