Provider Demographics
NPI:1215954714
Name:STOCK, MARC N (DPM)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:N
Last Name:STOCK
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:2201 W HOLCOMBE BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2096
Mailing Address - Country:US
Mailing Address - Phone:713-662-0333
Mailing Address - Fax:713-662-0387
Practice Address - Street 1:2201 W HOLCOMBE BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-662-0333
Practice Address - Fax:713-662-0387
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1218P213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4448230001Medicare NSC
TXU27713Medicare UPIN