Provider Demographics
NPI:1275626368
Name:MARSHALL, JAMES D (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-4268
Practice Address - Fax:682-885-7956
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL50362080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128918100OtherFIRSTCARE PIN
TX138412508Medicaid
TX1745806OtherFIRSTHEALTH PIN
TX84046GOtherBCBSTX IND PIN
TX00U87ZOtherBCBSTX GRP PIN
TX138412506Medicaid
TX152890301Medicaid
TX152890302Medicaid
TX1354679OtherUHC PIN
TX9205268OtherPHCS PIN
TX10007284OtherAMERIGROUP PIN
TX124153OtherSUPERIOR PIN
TX5231582OtherAETNA PIN
1750369203OtherGRP NPI NUMBER
TX6956476OtherCIGNA PIN
TX8721B7Medicare PIN
TX5231582OtherAETNA PIN
TX128918100OtherFIRSTCARE PIN