Provider Demographics
NPI:1801015482
Name:MCNEESE, MARSHA DIANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:DIANNE
Last Name:MCNEESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 BULLICK BLF
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1103
Mailing Address - Country:US
Mailing Address - Phone:512-266-7100
Mailing Address - Fax:512-266-5679
Practice Address - Street 1:7003 BULLICK BLF
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1103
Practice Address - Country:US
Practice Address - Phone:512-266-7100
Practice Address - Fax:512-266-5679
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0580174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE79348Medicare UPIN