Provider Demographics
NPI:1124410576
Name:STAATS, MARSHA ANN (MD)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:ANN
Last Name:STAATS
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 1:2311 ISLAND WOOD RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-2117
Mailing Address - Country:US
Mailing Address - Phone:512-263-9234
Mailing Address - Fax:512-263-4210
Practice Address - Street 1:2311 ISLAND WOOD RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78733-2117
Practice Address - Country:US
Practice Address - Phone:512-263-9234
Practice Address - Fax:512-263-4210
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6876207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine