Provider Demographics
NPI:1124061544
Name:DESCHAINE, MARC F (PA-C)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:F
Last Name:DESCHAINE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9000
Mailing Address - Fax:
Practice Address - Street 1:8300 FLOYD CURL DR
Practice Address - Street 2:3RD FL
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3931
Practice Address - Country:US
Practice Address - Phone:210-450-1170
Practice Address - Fax:210-450-1180
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01754363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX970027180OtherRAILROAD MEDICARE
TX7418315OtherAETNA
TX89N142OtherBCBS
TX970027180OtherRAILROAD MEDICARE
TX87N303Medicare PIN
TXTXB154137Medicare PIN