Provider Demographics
NPI:1992777460
Name:MARINA, JOSE MARIO JR (DO)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MARIO
Last Name:MARINA
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 4624
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4624
Mailing Address - Country:US
Mailing Address - Phone:956-583-7111
Mailing Address - Fax:956-583-7141
Practice Address - Street 1:1022 E GRIFFIN PKWY STE 108
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2401
Practice Address - Country:US
Practice Address - Phone:956-583-7111
Practice Address - Fax:956-583-7141
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2023-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK6125207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX041733904Medicaid
TXP00060053OtherPALMETTO GBA RAIL ROAD
TXG14194Medicare UPIN