Provider Demographics
NPI:1487250924
Name:GEORGE, MARSHALL ALEXANDER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:ALEXANDER
Last Name:GEORGE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 EMMETT PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-4563
Mailing Address - Country:US
Mailing Address - Phone:512-508-2624
Mailing Address - Fax:
Practice Address - Street 1:5980 KYLE PKWY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2400
Practice Address - Country:US
Practice Address - Phone:512-268-9713
Practice Address - Fax:512-262-0823
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist