Provider Demographics
NPI:1447287057
Name:MARSHALL, WINSTON SCHUYLER (MD)
Entity type:Individual
Prefix:
First Name:WINSTON
Middle Name:SCHUYLER
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 S US HIGHWAY 75 STE 300
Mailing Address - Street 2:ATTN. BILLING
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4589
Mailing Address - Country:US
Mailing Address - Phone:903-416-6325
Mailing Address - Fax:903-416-6326
Practice Address - Street 1:5012 S US HIGHWAY 75
Practice Address - Street 2:SUITE 100
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4587
Practice Address - Country:US
Practice Address - Phone:903-416-6325
Practice Address - Fax:903-416-6326
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6564207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132015209Medicaid
OK200217220AMedicaid
TXF93822Medicare UPIN
TX132015209Medicaid