Provider Demographics
NPI:1518285840
Name:NELL, MARINA MICHAELOVNA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:MICHAELOVNA
Last Name:NELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N LOOP 1604 E STE 125
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1255
Mailing Address - Country:US
Mailing Address - Phone:210-510-2868
Mailing Address - Fax:
Practice Address - Street 1:400 N LOOP 1604 E STE 125
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1255
Practice Address - Country:US
Practice Address - Phone:210-510-2868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ18682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry