Martin, Theresa A
Martin, Theresa A is an individual health care provider with primary practice located at 802 Medical Dr Ste 200 , Longview TX 75605-5201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Martin, Theresa A can be contacted via phone (903) 232-8297.Contact Information
Primary practice address
802 Medical Dr Ste 200
Longview TX 75605-5201
Phone: (903) 232-8297
Fax: (903) 553-7751
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | J6565 | Texas |
Profile Details
| NPI number | 1255308508 |
|---|---|
| LBN Legal business name | Martin, Theresa A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2006 |
| Last updated | Aug 26th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255308508 | NPPES |
| Texas | MEDICAID | 105981808 |
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