Martha Clark
Individual provider Active NPI Registered Nurse · Buda, TX
NPI 1609358795 · NPPES record last updated Sep 5, 2018
Key facts
- NPI
- 1609358795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 608393 (TX)
- Practice address
- 118 Tori Dr
Buda, TX 78610-9733 - Phone
- (512) 787-4146
- NPI assigned
- Sep 5, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 608393 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 608393 | TX | Yes |
Addresses
Primary practice location
118 Tori Dr
Buda, TX 78610-9733
Mailing address
118 Tori Dr
Buda, TX 78610-9733
Other providers in Buda, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.