Provider Demographics
NPI:1588346837
Name:MARKS, CONSETTA D
Entity type:Individual
Prefix:
First Name:CONSETTA
Middle Name:D
Last Name:MARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19442 CLEVERA WALK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6964
Mailing Address - Country:US
Mailing Address - Phone:832-882-3631
Mailing Address - Fax:
Practice Address - Street 1:19442 CLEVERA WALK LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6964
Practice Address - Country:US
Practice Address - Phone:832-882-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 253Z00000X, 305S00000X, 372500000X, 332U00000X, 372600000X, 347C00000X, 374U00000X, 376J00000X
TX374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172A00000XOther Service ProvidersDriver
No253Z00000XAgenciesIn Home Supportive Care
No305S00000XManaged Care OrganizationsPoint of Service
No372500000XNursing Service Related ProvidersChore Provider
No332U00000XSuppliersHome Delivered Meals
No372600000XNursing Service Related ProvidersAdult Companion
No347C00000XTransportation ServicesPrivate Vehicle
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker