Provider Demographics
NPI:1790951481
Name:MICHAEL D MARLOW, D.O., P.A.
Entity Type:Organization
Organization Name:MICHAEL D MARLOW, D.O., P.A.
Other - Org Name:MARLOW FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:936-321-4800
Mailing Address - Street 1:17350 ST LUKE'S WAY
Mailing Address - Street 2:STE 110
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4103
Mailing Address - Country:US
Mailing Address - Phone:936-321-4800
Mailing Address - Fax:936-273-4833
Practice Address - Street 1:17350 ST LUKES WAY
Practice Address - Street 2:STE 110
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4103
Practice Address - Country:US
Practice Address - Phone:936-321-4800
Practice Address - Fax:936-273-4833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1934207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH36711Medicare UPIN