Provider Demographics
NPI:1104848126
Name:FREEMAN, MARLA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLA
Middle Name:ANN
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 BERTNER AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2604
Mailing Address - Country:US
Mailing Address - Phone:832-355-2666
Mailing Address - Fax:
Practice Address - Street 1:ADVANCED DIAGNOSTICS HOSPITAL EAST
Practice Address - Street 2:12950 E FREEWAY SERVICE RD
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015
Practice Address - Country:US
Practice Address - Phone:713-330-3887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35096912207L00000X
TXP8243207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX334604102Medicaid
TX8EA953OtherBLUE CROSS BLUE SHIELD
TX3346074101Medicaid
TX3346074101Medicaid
TX34619YK6UMedicare PIN