Provider Demographics
NPI:1417079815
Name:MARC S. LITLE, M.D., P.A.
Entity type:Organization
Organization Name:MARC S. LITLE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:LITLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-361-8384
Mailing Address - Street 1:5944 LUTHER LN
Mailing Address - Street 2:STE. 800
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5942
Mailing Address - Country:US
Mailing Address - Phone:214-361-8384
Mailing Address - Fax:214-361-8454
Practice Address - Street 1:5944 LUTHER LN
Practice Address - Street 2:STE. 800
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5942
Practice Address - Country:US
Practice Address - Phone:214-361-8384
Practice Address - Fax:214-361-8454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ33442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty