MEDICARE: ANTONYA 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	363LF0000X	Family Nurse Practitioner	1180925	TX

General Provider Information

NPI Number	:	1578954301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONYA MARSHALL

Provider Business Mailing Address
First Line	:	8517 CROSS TIMBER TRL
Second Line	:
City	:	ROWLETT
State	:	TX
Zip	:	75089-1442
Country	:	US
Telephone Number	:	502-775-9862
Fax Number	:

Provider Business Practice Location Address
First Line	:	13350 TI BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-1512
Country	:	US
Telephone Number	:	972-817-6200
Fax Number	:

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

Provider Enumeration Date	:	02/16/2015
Last Update Date	:	05/14/2025

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Directions to “ ANTONYA MARSHALL ” Practice Location

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