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Individual

DR. JESUS MARCIAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2200 W ENNIS AVE, SUITE A, ENNIS, TX 75119-8054
(972) 875-8676
(972) 875-8481
Mailing address
2200 W ENNIS AVE, SUITE A, ENNIS, TX 75119-8054
(972) 875-8676
(972) 875-8481

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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