Provider Demographics
NPI:1396958203
Name:MARSHALL, BRESHENA D'ONNE (PA)
Entity type:Individual
Prefix:MS
First Name:BRESHENA
Middle Name:D'ONNE
Last Name:MARSHALL
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Gender:F
Credentials:PA
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Mailing Address - Street 1:3507 MERRELL RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-6042
Mailing Address - Country:US
Mailing Address - Phone:214-350-2411
Mailing Address - Fax:972-566-8164
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:C420
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-7976
Practice Address - Fax:972-566-8164
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXPA00061363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant