MEDICARE: KADESHA MARSHALL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		TX

General Provider Information

NPI Number	:	1407715444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KADESHA MARSHALL

Provider Business Mailing Address
First Line	:	14400 JFK BLVD APT 1224
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-1020
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14400 JFK BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-1018
Country	:	US
Telephone Number	:	254-630-2190
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “ KADESHA MARSHALL ” Practice Location

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