Provider Demographics
NPI:1639467384
Name:JE MARVEL MD ORTHOPEDICS PC
Entity Type:Organization
Organization Name:JE MARVEL MD ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MARVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-763-6144
Mailing Address - Street 1:108 PARKER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75783-2103
Mailing Address - Country:US
Mailing Address - Phone:903-763-6144
Mailing Address - Fax:
Practice Address - Street 1:108 PARKER ST STE 400
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:TX
Practice Address - Zip Code:75783-2103
Practice Address - Country:US
Practice Address - Phone:903-763-6144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0996174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty