Provider Demographics
NPI:1154612034
Name:JUNE MARSHALL,M.D.,P.A.
Entity type:Organization
Organization Name:JUNE MARSHALL,M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:GABRIELLE
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-697-2897
Mailing Address - Street 1:7333 NORTH FWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1300
Mailing Address - Country:US
Mailing Address - Phone:713-697-2897
Mailing Address - Fax:713-490-7248
Practice Address - Street 1:7333 NORTH FWY
Practice Address - Street 2:SUITE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-1300
Practice Address - Country:US
Practice Address - Phone:713-697-2897
Practice Address - Fax:713-490-7248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5961174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00F75TOtherMEDICARE ID
LA1649341OtherLOUISIANA PROVIDER NUMBER
TX10019905OtherAMERIGROUP
TX033218101Medicaid
LA1649341OtherLOUISIANA PROVIDER NUMBER