Provider Demographics
NPI:1851596423
Name:MARSHA E. THIGPEN, MD
Entity Type:Organization
Organization Name:MARSHA E. THIGPEN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:EVETTE
Authorized Official - Last Name:THIGPEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-729-5629
Mailing Address - Street 1:8128 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8014
Mailing Address - Country:US
Mailing Address - Phone:409-729-5629
Mailing Address - Fax:
Practice Address - Street 1:8128 9TH AVE
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8014
Practice Address - Country:US
Practice Address - Phone:409-729-5629
Practice Address - Fax:409-729-9408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1224261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC22574Medicare UPIN
TX00D94EMedicare ID - Type Unspecified