Basic Information
| Provider Information | |||||||||
| NPI: | 1386688281 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ISAACS | ||||||||
| FirstName: | S MARSHAL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5323 HARRY HINES BLVD | ||||||||
| Address2: | MC 8579 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753908579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146486739 | ||||||||
| FaxNumber: | 2146488423 | ||||||||
| Practice Location | |||||||||
| Address1: | 5323 HARRY HINES BLVD | ||||||||
| Address2: | MC 8579 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753908579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146486739 | ||||||||
| FaxNumber: | 2146488423 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 10/14/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | M4825 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00156837 | 01 | CA | RAILROAD MEDICARE | OTHER | OOG719350 | 05 | CA | MEDICAID |