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NPI Code Detail

MEDICARE: DR. MARTHA JANE WADE DDS

MEDICARE: DR. MARTHA JANE WADE DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry11929TX

General Provider Information

NPI Number : 1013119643
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARTHA JANE WADE DDS
Provider Business Mailing Address
First Line : 424 HAHLO ST.
Second Line : DENVER HARBOR CLINIC
City : HOUSTON
State : TX
Zip : 77020-3022
Country : US
Telephone Number : 713-674-3326
Fax Number :
Provider Business Practice Location Address
First Line : 424 HAHLO ST
Second Line :
City : HOUSTON
State : TX
Zip : 77020-3022
Country : US
Telephone Number : 713-674-3326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2007
Last Update Date : 03/12/2012

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Directions to “ DR. MARTHA JANE WADE DDS” Practice Location

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