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Individual
DR. JESUS MARCIAL
Active
Individual
DR. JESUS MARCIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9980
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186463901
—
TX
01
—
608125
BLUE CROSS PROVIDER ID
TX
01
—
9380653
PHCS PROVIDER ID
TX
Enumeration date
08/09/2005
Last updated
02/13/2020
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