Individual
JUNE GABRIELLE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11307 FM 1960 RD W, STE 230, HOUSTON, TX 77065-3687
(910) 676-2509
Mailing address
11307 FM 1960 RD W, STE 230, HOUSTON, TX 77065-3687
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G5961
TX
207V00000X
Obstetrics & Gynecology Physician
Primary
G5961
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F75T
MEDICARE ID
TX
05
—
033218101
—
TX
01
—
10019905
AMERIGROUP
TX
01
—
1649341
LOUISIANA PROVIDER NUMBER
LA
Enumeration date
09/20/2006
Last updated
02/10/2022
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