Provider Demographics
NPI:1992307540
Name:BILLS, MARCUS KARLTONIAN (LCDC)
Entity type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:KARLTONIAN
Last Name:BILLS
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WINDSONG
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-2662
Mailing Address - Country:US
Mailing Address - Phone:903-905-2325
Mailing Address - Fax:
Practice Address - Street 1:1200 VAN ZANDT ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-3196
Practice Address - Country:US
Practice Address - Phone:903-785-8638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15355101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty