Provider Demographics
NPI:1922190925
Name:MARR, WILLIAM H (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:MARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4515
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77805-4515
Mailing Address - Country:US
Mailing Address - Phone:979-776-7564
Mailing Address - Fax:979-776-0873
Practice Address - Street 1:3030 UNIVERSITY DR E STE 100
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6147
Practice Address - Country:US
Practice Address - Phone:979-776-7564
Practice Address - Fax:979-776-0873
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6907207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083529001Medicaid
TX80V415Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE