Individual
MARY WADE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3610 STAGG DR, BEAUMONT, TX 77701-3713
(409) 923-0012
(409) 291-8010
Mailing address
3610 STAGG DR, BEAUMONT, TX 77701-3713
(409) 923-0012
(409) 291-8010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23664
OK
207V00000X
Obstetrics & Gynecology Physician
Primary
23664
OK
Other
Enumeration date
07/27/2006
Last updated
05/11/2021
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