Individual
MARTHA FAVELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7501 WESTOVER PL, AMARILLO, TX 79119-7342
(806) 681-0639
Mailing address
7501 WESTOVER PL, AMARILLO, TX 79119-7342
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
105606
TX
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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