Basic Information
| Provider Information | |||||||||
| NPI: | 1720094915 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARROY | ||||||||
| FirstName: | LARRY | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 HIGHLANDER BLVD | ||||||||
| Address2: | SUITE 415 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760154330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175168811 | ||||||||
| FaxNumber: | 8175168444 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 HIGHLANDER BLVD | ||||||||
| Address2: | SUITE 415 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760154330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175168811 | ||||||||
| FaxNumber: | 8175168444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 09/05/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | H4075 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | P000A27X6 | 05 | TX | MEDICAID |