Provider Demographics
NPI:1285394015
Name:MARCELO BRITO MD, PLLC
Entity type:Organization
Organization Name:MARCELO BRITO MD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/FAMILY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:BRITO TELLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:779-770-7011
Mailing Address - Street 1:2812 DORSET
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3592
Mailing Address - Country:US
Mailing Address - Phone:779-770-7011
Mailing Address - Fax:
Practice Address - Street 1:713 HEBRON PKWY STE 220
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-5135
Practice Address - Country:US
Practice Address - Phone:972-315-8588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty