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Individual

MRS. MARY LOUISE MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
EMT-I

Contact information

Practice address
3190 PITTMAN RD, SAINT HEDWIG, TX 78152-3602
(210) 667-1001
Mailing address
3190 PITTMAN RD, SAINT HEDWIG, TX 78152-3602
(210) 667-1001

Taxonomy

Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
36210
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36210
TEXAS DEPARTMENT OF HEALTH SERVICES
TX
Enumeration date
12/09/2009
Last updated
12/09/2009
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