Provider Demographics
NPI:1972746162
Name:ORLOWSKI, MARCUS T
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:T
Last Name:ORLOWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17430 CAMPBELL RD
Mailing Address - Street 2:#112
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5212
Mailing Address - Country:US
Mailing Address - Phone:214-628-9047
Mailing Address - Fax:214-628-9049
Practice Address - Street 1:17430 CAMPBELL RD STE 112
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5297
Practice Address - Country:US
Practice Address - Phone:214-628-9047
Practice Address - Fax:214-628-9049
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012467251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health