ROBERT MARRIOTT MEDICAL CORP (NPI# 1568913010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568913010 |
| Entity Type | Organization |
| Organization Name | ROBERT MARRIOTT MEDICAL CORP |
| Practice Address |
330 W Ben White Blvd Austin TX 78704-8095 |
| Mailing Address |
222 N Pacific Coast Hwy Ste 2175 El Segundo CA 90245-5639 |
| Practice Telephone | 8778783289 |
| Practice Fax Number | 8778173227 |
| Mailing Telephone | 8778783289 |
| Mailing Fax Number | 8778173227 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2018-11-08 |
| Authorized Official Name | ROBERT J MARRIOTT (CEO) |
| Authorized Official Telephone | 8778783289 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVANTAGE WOUND CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 3538365 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003367566 | Robert Marriott Medical Corp | Surgery | 713 Midway Ave, Mount Airy, MD 21771-2833 | 2016-10-19 |
| 1467903914 | Robert Marriott Medical Corp | Surgery | 2644 Bristol Rd, Warrington, PA 18976-1404 | 2016-10-19 |
| 1093266553 | Robert Marriott Medical Corp | Surgery | 103 W Martial Ave, Lafayette, LA 70508-6719 | 2016-10-19 |
| 1003367558 | Robert Marriott Medical Corp | Surgery | 113 W Essex St, Maywood, NJ 07607-1023 | 2016-10-19 |
| 1518418128 | Robert Marriott Medical Corp | Surgery | 4900 E Berry St, Fort Worth, TX 76105-4314 | 2016-10-18 |
| 1356892962 | Robert Marriott Medical Corp | Surgery | 130 Spencer Ln, San Antonio, TX 78201-2109 | 2016-10-18 |
| 1073064689 | Robert Marriott Medical Corp | Surgery | 1175 Denton St, Beaumont, TX 77707-3913 | 2016-10-18 |
| 1619428562 | Robert Marriott Medical Corp | Surgery | 603 E Plantation Dr, Clute, TX 77531-5719 | 2016-10-16 |
| 1164973012 | Robert Marriott Medical Corp | Surgery | 711 Matador Ln, Mesquite, TX 75149-8830 | 2016-10-16 |
| 1083883938 | Robert Marriott Medical Corp | Surgery | 222 N Pacific Coast Hwy Ste 2175, El Segundo, CA 90245-5639 | 2008-02-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ROBERT MARRIOTT MEDICAL CORP. | 28 Liberty Street, New York, New York 10005 |
| Virginia Business Entities | Robert Marriott Medical Corp. | 222 N Pacific Coast Hwy Ste 2175, El Segundo, California 90245-5639 |
| Oregon Corporations, Companies and Business Names | ROBERT MARRIOTT MEDICAL CORP. | 222 North Pacific Coast Hwy, Ste 2175, El Segundo, CA 90245 |
| Oklahoma Business Registrations | ROBERT MARRIOTT MEDICAL CORP. | 863 N Douglas Street, Suite 100, El Segundo, CA 90245 |
| Colorado Business Entities | ROBERT MARRIOTT MEDICAL CORP. | 222 North Pacific Coast Hwy., Ste 1420, El Segundo, CA 90245-5639 |
| Connecticut Business Registrations | ROBERT MARRIOTT MEDICAL CORP. | 222 N Sepulveda Blvd, Suite 2175, El Segundo, CA 90245 |
| Street Address |
330 W BEN WHITE BLVD |
| City | AUSTIN |
| State | TX |
| Zip Code | 78704-8095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235100462 | Mark D Bogar | Physical Medicine & Rehabilitation | 330 W Ben White Blvd, Austin, TX 78704-8095 | 2006-01-27 |
| 1285250506 | Ocotillo Rehab Medicine Pllc | Physical Medicine & Rehabilitation | 330 W Ben White Blvd, Austin, TX 78704-8095 | 2020-06-23 |
| 1689156812 | Marica Baricuatro | Nurse Practitioner | 330 W Ben White Blvd, Austin, TX 78704-8095 | 2018-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494018 | 340b Partners Pharmacy - Dallas LLC | Pharmacy | 2800 S Ih 35 Frontage Rd, Suite 105, Austin, TX 78704 | 2020-10-12 |
| 1740802206 | Roots, Aba Therapy and Consulting Services LLC | Behavioral Analyst | 3715 S. 1st St, #464, Austin, TX 78704 | 2020-05-07 |
| 1447896071 | Stefanie Van Hoose Mott | Nurse Practitioner | 2800 South Ih 35 Frontage Road #100, Austin, TX 78704 | 2019-11-19 |
| 1902463219 | Melanie Rabalais Lpc, Pllc | Counselor | 3111 Dickson Dr, Suite 33, Austin, TX 78704 | 2019-05-22 |
| 1023590866 | Roberto Carlos Guerra | Physical Therapy Assistant | 2515 S Ih 35, Ste 320, Austin, TX 78704 | 2018-08-29 |
| 1750875118 | Kristen Gabrielle Ferrante | Dentist | 2330 S Lamar Blvd, Austin, TX 78704 | 2018-06-19 |
| 1366944555 | Beryl Hoelscher | Registered Nurse | 706 W Ben White Blvd Ste 233a, Austin, TX 78704 | 2018-03-02 |
| 1780103861 | Remedy Pediatrics Pllc | Pediatrics | 2512 South Interstate 35 Frontage Rd., Suite 310, Austin, TX 78704 | 2017-09-11 |
| 1285176172 | Leah Nichole Burandt | Physician Assistant | 2512 S Interstate 35 Ste 310, Austin, TX 78704 | 2016-11-09 |
| 1659822690 | Kristin Jarrett | Physical Therapist | 1524 S I-35, Suite 300, Austin, TX 78704 | 2016-10-14 |
| Find all providers in zip 78704 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689222663 | Carol Kim Le | Surgery | 502 Wilmes Dr, Austin, TX 78752-4139 | 2019-09-03 |
| 1891266144 | Jeanelle Denise Pickering-wolski | Surgery | 4700 Seton Center Pkwy Ste 100, Austin, TX 78759-6215 | 2018-12-16 |
| 1780115501 | Charles Edward Hill IIi | Surgery | Ut Austin Dell Medical School General Surgery Education, 1500 Red River St, Annex, Austin, TX 78701 | 2017-03-23 |
| 1972918951 | Surgery Southwest Austin Pllc | Surgery | 410 E 5th St, Unit 309, Austin, TX 78701-3700 | 2014-06-27 |
| 1316387061 | Shey Kyle Ditto | Surgery | 201 Wester Ross Ln, Austin, TX 78738 | 2013-06-26 |
| 1851692784 | Pedro Gustavo R Teixeira | Surgery | 1301 W 38th St Ste 400, Austin, TX 78705-1017 | 2010-11-09 |
| 1306162805 | Aileen Ebadat | Surgery | 4007 James Casey St Ste B140, Austin, TX 78745-3328 | 2010-04-09 |
| 1700011590 | Lauren Gayle Ash | Surgery | 7900 Fm 1826 Ste 180, Building 1, Austin, TX 78737-1408 | 2009-05-21 |
| 1871741900 | Hyon Christopher Shin, M.d., P.a. | Surgery | 9011 Mountain Ridge Dr Ste 140, Austin, TX 78759-7369 | 2008-09-03 |
| 1861648933 | Jessica Ann Naiditch | Surgery | 1301 Barbara Jordan Blvd Ste 400, Austin, TX 78723-3078 | 2008-08-08 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.