Individual
MRS. MARILYN MARTIN PETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-RX AUTH
Contact information
Practice address
1141 KELLER PKWY, SUITE A, KELLER, TX 76248-1627
(817) 741-2601
(817) 745-2601
Mailing address
1141 KELLER PKWY, SUITE A, KELLER, TX 76248-1627
(817) 741-2601
(817) 745-2601
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
685722
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578768701
GROUP NPI
TX
Enumeration date
03/29/2010
Last updated
03/29/2010
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