Basic Information
| Provider Information | |||||||||
| NPI: | 1194737320 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARSHALL | ||||||||
| FirstName: | GORDON | ||||||||
| MiddleName: | P. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 42680 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787040043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123262800 | ||||||||
| FaxNumber: | 5124416388 | ||||||||
| Practice Location | |||||||||
| Address1: | 4310 JAMES CASEY ST | ||||||||
| Address2: | SUITE 3C | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123262800 | ||||||||
| FaxNumber: | 5124416388 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 08/27/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | K8326 | TX | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | 207X00000X | K8326 | TX | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.