Individual
ROBERT LARRY MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2660
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2660
(817) 735-2673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D9846
TX
207RR0500X
Rheumatology Physician
Primary
D9846
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114096404
—
TX
01
—
8X9560
BCBS
TX
01
—
P00415560
RAILROAD MEDICARE
TX
Enumeration date
06/26/2007
Last updated
12/17/2009
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