Provider Demographics
NPI:1508209628
Name:MARCANTEL, ASHLEY ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ARNOLD
Last Name:MARCANTEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1600 W LEAGUE CITY PKWY
Mailing Address - Street 2:SUITE M
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6442
Mailing Address - Country:US
Mailing Address - Phone:281-992-5914
Mailing Address - Fax:
Practice Address - Street 1:1600 W LEAGUE CITY PKWY
Practice Address - Street 2:SUITE M
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6442
Practice Address - Country:US
Practice Address - Phone:281-992-5914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR2403207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program