NPIMap

Organization Active NPI

Mark a. Marconi, D.O., P.a.

Doing business as Gulf Coast Family Medicine

  • Family Medicine Physician
  • Wharton, TX
National Provider Identifier
1447473319
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K9342 Issued in TX
Legal business name
MARK A. MARCONI, D.O., P.A.
Doing business as
Gulf Coast Family Medicine
Practice address
10119 US 59 Hwy
Wharton, TX 77488-7224
Phone
(979) 532-1159
Fax
(979) 532-2119
NPI assigned
Apr 10, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark A Marconi, D.O.
Title
President
Phone
(979) 532-1159

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K9342 TX Primary

Addresses

Primary practice location

10119 US 59 Hwy
Wharton, TX 77488-7224

Mailing address

PO Box 1128
Wharton, TX 77488-1128
Phone (979) 532-1159

Other identifiers 1

IdentifierTypeStateIssuer
158638001MedicaidTX

Other names 1

  • Gulf Coast Family Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

10119 US 59 Hwy
Wharton, TX 77488
Phone 9792452008302

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1447473319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774881128",
            "telephone_number": "979-532-1159",
            "fax_number": "979-532-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10119 US 59 HWY",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774887224",
            "telephone_number": "979-532-1159",
            "fax_number": "979-532-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. MARCONI, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MARCONI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-532-1159",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K9342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158638001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wharton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.