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Individual

DR. THERESA A MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
802 MEDICAL DR STE 200, LONGVIEW, TX 75605-5201
(903) 232-8297
(903) 553-7751
Mailing address
PO BOX 19036, BELFAST, ME 04915-4085
(903) 381-7263
(903) 381-7269

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
J6565
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
105981808
TX
Enumeration date
03/07/2006
Last updated
08/26/2020
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