Marcus L. Weatherall Jr., MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

N4195 Issued in TX

Practice address

5201 Harry Hines Blvd
House Staff & Gme
Dallas, TX 75235

Phone

(214) 590-8058

NPI assigned

May 9, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Texas Medicine Resources, LLP

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1376581900
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1568639508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599",
            "telephone_number": "214-590-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "address_2": "HOUSE STAFF & GME",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75235",
            "telephone_number": "214-590-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERALL",
        "first_name": "MARCUS",
        "middle_name": "L.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N4195",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devri Lane Weakley, MD
• Joanna Weakley, PT
• Kathleen Wear, DPT
• Jessalyn Mae Weary, PA-C
• Daniel Paul Weatherall, M.D.
• Paul Theodore Weatherall, MD
• David Lee Weatherford, QMHP-CS
• Emma Weatherford, MSC
• Ramona R Weatherford, LCSW
• Domonique Denise Weathers, DO

• Emergency Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.