Provider Demographics
NPI:1740240423
Name:MARSHALL, BRIAN DEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DEAN
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17000 PRESTON RD
Mailing Address - Street 2:STE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:972-250-2020
Mailing Address - Fax:972-239-0840
Practice Address - Street 1:17000 PRESTON RD
Practice Address - Street 2:STE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1233
Practice Address - Country:US
Practice Address - Phone:972-239-1530
Practice Address - Fax:972-239-0840
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4373T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT410001142Medicare ID - Type Unspecified
T95917Medicare UPIN