Active NPI
Romona Martin
- Contractor
- Beaumont, TX
National Provider Identifier
1104362995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 21958694
- Practice address
- 3260 Roberts St
Beaumont, TX 77701-6536 - Phone
- (409) 363-9586
- Fax
- (409) 861-0168
- NPI assigned
- Jan 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 21958694 | TX | Primary |
Addresses
Primary practice location
3260 Roberts St
Beaumont, TX 77701-6536
Mailing address
3260 Roberts St
Beaumont, TX 77701-6536
Phone (409) 363-9586
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21958694 | TX | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484611200000",
"number": "1104362995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3260 ROBERTS ST",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777016536",
"telephone_number": "409-363-9586",
"fax_number": "409-861-0168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3260 ROBERTS ST",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777016536",
"telephone_number": "409-363-9586",
"fax_number": "409-861-0168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ROMONA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-17",
"last_updated": "2017-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TX",
"license": "21958694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.