Provider Demographics
NPI:1962452961
Name:MARNELL, TORI I (MD)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:I
Last Name:MARNELL
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:PO BOX 51
Mailing Address - Street 2:
Mailing Address - City:TULIA
Mailing Address - State:TX
Mailing Address - Zip Code:79088-0051
Mailing Address - Country:US
Mailing Address - Phone:806-994-0384
Mailing Address - Fax:
Practice Address - Street 1:911 23RD ST
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-4645
Practice Address - Country:US
Practice Address - Phone:806-655-2104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100985403Medicaid
00314FMedicare ID - Type Unspecified
G69930Medicare UPIN