Provider Demographics
NPI:1245571967
Name:MARSHALL, LARRY DONATHAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:DONATHAN
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3703
Mailing Address - Country:US
Mailing Address - Phone:210-566-6508
Mailing Address - Fax:
Practice Address - Street 1:2908 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-3703
Practice Address - Country:US
Practice Address - Phone:210-566-6508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist