Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | M4428 | TX |
Y | 208000000X | Pediatrician | M4428 | TX |
NPI | 1659435626 |
---|---|
Provider Name | Parul V Martin |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76244-2118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 06/05/2021 |