Individual ProviderMarina KonoplevaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1515 Holcombe Blvd, Houston, TX 77030-4000(713) 792-6161(713) 792-2991PECOS EnrollmentBased on the most recent information from CMS, provider Marina Konopleva is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:26 AM.Profile DetailsProvider ID1518063486Provider TypeIndividualFull NameKonopleva, MarinaCredentialM.D. PHDGenderFemaleSole ProprietorNoEnumeration Date9/16/2006Last Updated10/25/2022Contact InformationPractice LocationPractice Address1515 Holcombe Blvd, Houston, TX 77030-4000Phone(713) 792-6161FaxUnlisted FaxMailing LocationMailing AddressPO Box 4439, Houston, TX 77210-4439Phone(713) 792-2991FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RH0003XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseN4530TexasCode207RH0003XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense319070-01New YorkCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense41493TexasProvider IdentifiersIDDescriptionIssuerID175523302DescriptionMedicaidIssuerUnlistedTexas