Provider Demographics
NPI:1851379093
Name:MARSH, ROYDEN W (MD)
Entity Type:Individual
Prefix:
First Name:ROYDEN
Middle Name:W
Last Name:MARSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 PHEASANT RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2507 KENNEDY CIR
Practice Address - Street 2:
Practice Address - City:BROOKS CITY-BASE
Practice Address - State:TX
Practice Address - Zip Code:78235-5116
Practice Address - Country:US
Practice Address - Phone:210-536-3107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG41672084P0800X
CO196802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry