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Individual

MS. MARTHA J ETHRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
514 DEEPGROVE DR, HOUSTON, TX 77037-4012
(281) 380-1375
Mailing address
514 DEEPGROVE DR, HOUSTON, TX 77037-4012
(281) 380-1375

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
88439
TX
341600000X
Ambulance
Primary
88439
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
170939601
TX
Enumeration date
09/13/2007
Last updated
03/27/2009
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