Provider Demographics
NPI:1750919726
Name:MARRI, TEJASWI (MD)
Entity type:Individual
Prefix:
First Name:TEJASWI
Middle Name:
Last Name:MARRI
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 1:3625 N HALL ST STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5106
Mailing Address - Country:US
Mailing Address - Phone:214-252-3500
Mailing Address - Fax:214-252-0527
Practice Address - Street 1:3625 N HALL ST STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5106
Practice Address - Country:US
Practice Address - Phone:214-252-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV0040207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology