Provider Demographics
NPI:1326529546
Name:POHORELSKY, MARSHA SUE (APRN)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:SUE
Last Name:POHORELSKY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 E RAILROAD ROW
Mailing Address - Street 2:
Mailing Address - City:GIDDINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78942-2639
Mailing Address - Country:US
Mailing Address - Phone:979-542-9000
Mailing Address - Fax:
Practice Address - Street 1:219 E RAILROAD ROW
Practice Address - Street 2:
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78942-2639
Practice Address - Country:US
Practice Address - Phone:979-542-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-25
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138588207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine