MEDICARE: MARSHALL B ROBERT MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	N5364	TX

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080156896	OTHER	IL	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	343059	OTHER	IL	HEALTHLINK
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	9150613	OTHER	IL	UNICARE
6	08526614	OTHER	IL	BCBS OF ILLINOIS
7	060286	OTHER	IL	HEALTH ALLIANCE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1538101605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHALL B ROBERT MD

Provider Business Mailing Address
First Line	:	211 E 7TH ST STE 700
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-3218
Country	:	US
Telephone Number	:	888-478-8432
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 S HAMPTON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-5617
Country	:	US
Telephone Number	:	888-478-8432
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	06/13/2024

306 S HAMPTON RD STE 322
DALLAS, TX
75208-5617

Practice Phone: 469-501-9205
Practice Fax: 469-629-1179