Individual provider Active NPI

Marchell E Thurow

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1750547618
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07885 Issued in TX
Practice address
1999 Bryan St Ste 900
Dallas, TX 75201-3140
Phone
(574) 546-1900
Fax
(574) 546-1999
NPI assigned
Jul 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0681 SD
Physician Assistant 363A00000X PA07885 TX Primary

Addresses

Primary practice location

1999 Bryan St Ste 900
Dallas, TX 75201-3140

Mailing address

2100 N Main St Ste 304
Crown Point, IN 46307-1877
Phone (574) 546-1900

Other practice location 1

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-3441

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121018000407 TX Practitioner - Physician Assistant 9234205162 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0681SDMDAthletic Trainer
PA07885TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vericare of Texas, P.a. CurrentSince Sep 16, 2015 Accepting new patients

Locations

901 Central Texas Expy
Lampasas, TX 76550
Phone (512) 556-8827

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1750547618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST STE 304",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071877",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 BRYAN ST STE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013140",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 W Martin St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782070903",
            "country_code": "US",
            "telephone_number": "210-358-3441",
            "fax_number": "210-358-5944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THUROW",
        "first_name": "MARCHELL",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": "0681",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.