Active NPI
Cttdd Family Practice
- Clinic/Center
- Marshall, TX
National Provider Identifier
1548089865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- CTTDD FAMILY PRACTICE
- Practice address
- 402 S Bolivar St
Marshall, TX 75670-4110 - Phone
- (903) 935-9105
- NPI assigned
- Oct 3, 2024
- Last updated
- Oct 3, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tolesia Davis
- Title
- Manager
- Phone
- (903) 742-9416
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
402 S Bolivar St
Marshall, TX 75670-4110
Mailing address
402 S Bolivar St
Marshall, TX 75670-4110
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727913600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727913600000",
"number": "1548089865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 S BOLIVAR ST",
"city": "MARSHALL",
"state": "TX",
"postal_code": "756704110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 S BOLIVAR ST",
"city": "MARSHALL",
"state": "TX",
"postal_code": "756704110",
"telephone_number": "903-935-9105"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CTTDD FAMILY PRACTICE",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-03",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "TOLESIA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "903-742-9416"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, TX
- Alexus Anese Cotton
- Counseling and Psychological Services of East Texas, PC
- Jennifer Courtney, CPM, LM
- Hanna Leigh Coyle, FNP
- Steven Carlos Crayton, MD
- CVS Pharmacy Inc (CVS Pharmacy #07293)
- David L Nelson, Doctor of Optometry, PA
- Austin B Davidson, APN
- Dawn Whelchel MHT LLC
- Dayspring Therapeutic Equestrian Center of Harrison County Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.