Provider Demographics
NPI:1578182432
Name:MARSHALL, CHRISTIAN WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:WILLIAM
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 PONTIUS DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2753
Mailing Address - Country:US
Mailing Address - Phone:281-684-3530
Mailing Address - Fax:
Practice Address - Street 1:1922 PONTIUS DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2753
Practice Address - Country:US
Practice Address - Phone:281-684-3530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty