Provider Demographics
NPI:1164813754
Name:SERRANO, MARCO ANTONIO (RPA)
Entity type:Individual
Prefix:
First Name:MARCO
Middle Name:ANTONIO
Last Name:SERRANO
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19234 STONEHUE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3477
Mailing Address - Country:US
Mailing Address - Phone:210-481-9544
Mailing Address - Fax:210-481-9545
Practice Address - Street 1:19234 STONEHUE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3477
Practice Address - Country:US
Practice Address - Phone:210-481-9544
Practice Address - Fax:210-481-9545
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20751243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant