Provider Demographics
NPI:1629018858
Name:MARLOW, GEORGE SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:SCOTT
Last Name:MARLOW
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 650865
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0865
Mailing Address - Country:US
Mailing Address - Phone:972-715-5007
Mailing Address - Fax:972-715-5682
Practice Address - Street 1:6606 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6524
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2959207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EH574OtherBCBS TX
TX8X1973OtherBCBS
TX125412005Medicaid
TX125412006Medicaid
TX125412007Medicaid
TXP00662061OtherRR MEDICARE
TX099179603Medicaid
TX8X1985OtherBCBS
TX125412006Medicaid
TX099179603Medicaid
TX351964YK6UMedicare PIN
TX8J1242Medicare PIN