| Marwan Purghol, M.d. | |
|
2001 9th Ave Suite 201 Port Arthur TX 77642-2701 | |
| (409) 729-6700 | |
| (409) 729-6705 |
| Full Name | Marwan Purghol, M.d. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2001 9th Ave, Port Arthur, Texas |
| Authorized Official Name and Position | Wendy Rebecca Roller (OFFICE MANAGER) |
| Authorized Official Contact | 4097296700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marwan Purghol, M.d. Po Box 1283 Nederland TX 77627-1283 Ph: (409) 729-6700 | Marwan Purghol, M.d. 2001 9th Ave Suite 201 Port Arthur TX 77642-2701 Ph: (409) 729-6700 |
| NPI Number | 1528197712 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 09/09/2010 |
| Medicare PECOS PAC ID | 2466405634 |
|---|---|
| Medicare Enrollment ID | O20050228000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528197712 | NPI | - | NPPES |
| 0004MG | Other | TX | BC |
| 047623603 | Medicaid | TX | |
| 8R7190 | Other | TX | BC |
| L0520 | Other | TX | TEXAS MEDICAL LICENSE |
| 174447601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | L0520 (Texas) | Primary |
| Provider Name | Marwan Purghol |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689607350 PECOS PAC ID: 4981657152 Enrollment ID: I20050301000337 |
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