NPIMap

Organization Active NPI

Aj Marshall Medical, PLLC

Doing business as Quality of Life Medical Center

  • Multi-Specialty Clinic/Center
  • Magnolia, TX
National Provider Identifier
1669181707
Registry record updated Nov 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
AJ MARSHALL MEDICAL, PLLC
Doing business as
Quality of Life Medical Center
Practice address
6910 FM 1488 Rd Ste 3
Magnolia, TX 77354-1540
Phone
(281) 789-4182
Fax
(281) 789-7636
NPI assigned
Nov 17, 2022
Last updated
Nov 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2022

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

Authorized official

Name
Mr. Aaron Marshall
Title
Cfo
Phone
(281) 789-4182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

6910 FM 1488 Rd Ste 3
Magnolia, TX 77354-1540

Mailing address

6910 FM 1488 Rd Ste 3
Magnolia, TX 77354-1540

Other practice location 1

17099 Walden Rd Ste 100
Montgomery, TX 77356-3249
Phone (936) 703-2610

Other names 1

  • Quality of Life Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230112001826 TX Part B Supplier - Clinic/Group Practice 8325418106 Receives reassigned benefits from 8 practitioners
Practice locations: Magnolia, TX
O20240416002040 TX DME Supplier - Multi-Specialty - Physician 8325418106 Practice locations: Magnolia, TX

National Provider Directory

National Provider Directory

Locations

6910 FM 1488 Rd
Ste 3
Magnolia, TX 77354
Phone (281) 630-3836

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668816000000",
    "number": "1669181707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 FM 1488 RD STE 3",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773541540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 FM 1488 RD STE 3",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773541540",
            "telephone_number": "281-789-4182",
            "fax_number": "281-789-7636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17099 Walden Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "TX",
            "postal_code": "773563249",
            "country_code": "US",
            "telephone_number": "936-703-2610",
            "fax_number": "936-272-0999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AJ MARSHALL MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-19",
        "certification_date": "2022-11-19",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "281-789-4182",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality of Life Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Magnolia, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.