Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 13207 | TX |
N | 111NN1001X | Nutrition | 13207 | TX |
NPI | 1003577487 |
---|---|
Provider Name | Dr. Bronwen Martin |
First Address | Houston, TX 77019-6309 |
Second Address | Houston, TX 77019-6309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2022 |
Last Update Date | 06/01/2022 |