Provider Demographics
NPI:1639124035
Name:NUBY, MARQUIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARQUIS
Middle Name:J
Last Name:NUBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 BENT OAKS CT
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-3300
Mailing Address - Country:US
Mailing Address - Phone:940-566-5437
Mailing Address - Fax:940-323-0553
Practice Address - Street 1:1208 BENT OAKS CT
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-3300
Practice Address - Country:US
Practice Address - Phone:940-566-5437
Practice Address - Fax:940-323-0553
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7827208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178582602OtherMEDICAID THS
TX162506304Medicaid
TX10046733OtherAMERIGROUP
TX8V1060OtherBCBS TX
TX162506304Medicaid