Provider Demographics
NPI:1679559009
Name:LONGO, MARC NARCISO (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:NARCISO
Last Name:LONGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7500 SAN FELIPE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1709
Mailing Address - Country:US
Mailing Address - Phone:713-953-9932
Mailing Address - Fax:
Practice Address - Street 1:7500 SAN FELIPE ST
Practice Address - Street 2:200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1707
Practice Address - Country:US
Practice Address - Phone:713-953-9932
Practice Address - Fax:713-953-0380
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ0077207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8764K0Medicare ID - Type Unspecified