Provider Demographics
NPI:1235199944
Name:ALLEN, MARSHA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:M
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:13409 GEORGE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3064
Mailing Address - Country:US
Mailing Address - Phone:210-492-8922
Mailing Address - Fax:210-479-2010
Practice Address - Street 1:1147 CANTWELL LN
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78407-1705
Practice Address - Country:US
Practice Address - Phone:361-289-3111
Practice Address - Fax:866-370-0223
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2012-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL3225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F6638Medicare UPIN