Provider Demographics
NPI:1598734105
Name:STARKS, MARION E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:E
Last Name:STARKS
Suffix:
Gender:M
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:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:6606 LBJ FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3621207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EH516OtherBCBS
TX133056509Medicaid
TX133056517Medicaid
TXP01355551OtherRR
TX337808YK6UMedicare PIN
TX8EH516OtherBCBS
TX133056509Medicaid
TX8L307600Medicare PIN
TX133056512Medicaid
TX8L20107Medicare PIN
TX133056516OtherMEDICAID CSHCN
TX337808YK6UMedicare PIN
TX133056515OtherMEDICAID CSHCN
TXF07803Medicare UPIN
TX133056511Medicaid
TXTXB151001Medicare PIN