Healthcare Provider Details

I. General information

NPI: 1376571687
Provider Name (Legal Business Name): THOMAS E MARSHALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 BIRDSONG DR STE A
BAYTOWN TX
77521-3771
US

IV. Provider business mailing address

21502 MERCHANTS WAY
KATY TX
77449-2517
US

V. Phone/Fax

Practice location:
  • Phone: 281-422-2020
  • Fax: 281-422-4959
Mailing address:
  • Phone: 281-944-2232
  • Fax: 281-944-2290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberH0603
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: