Basic Information
| Provider Information | |||||||||
| NPI: | 1740374867 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARR | ||||||||
| FirstName: | BYRON | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8411 STERLING ST | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750631901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729296633 | ||||||||
| FaxNumber: | 9729291313 | ||||||||
| Practice Location | |||||||||
| Address1: | 8411 STERLING ST | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750631901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729296633 | ||||||||
| FaxNumber: | 9729291313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2085R0202X | 3828 | OK | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.