Provider Demographics
NPI:1124320031
Name:MARSHALL, DEBRA
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 SUTTER PARK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-3944
Mailing Address - Country:US
Mailing Address - Phone:281-580-2505
Mailing Address - Fax:281-890-6122
Practice Address - Street 1:6323 SUTTER PARK LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-3944
Practice Address - Country:US
Practice Address - Phone:281-580-2505
Practice Address - Fax:281-890-6122
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver