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General NPI Number Information
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NPI Number | 1841616109
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Entity Type | Organization
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Legal Business Name | MARSHALL EYE CARE
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 17370 PRESTON RD STE 410
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City | DALLAS
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State | TX
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Zip | 75252-5611
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Country | US
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Telephone | 972-250-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 10935 TULAROSA LN
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City | FRISCO
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State | TX
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Zip | 75033-1767
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN MARSHALL
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Credential | O.D.
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Telephone | 972-250-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4373TG
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License Number State | TX
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