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NPI Code Detail

MEDICARE: MRS. MARTHA W NYE LCSW

MEDICARE: MRS. MARTHA W NYE LCSW
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
11041C0700XClinical Social Worker08451TX

General Provider Information

NPI Number : 1205868601
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARTHA W NYE LCSW
Provider Business Mailing Address
First Line : 1380 RIVER BEND DR
Second Line :
City : DALLAS
State : TX
Zip : 75247-4914
Country : US
Telephone Number : 214-743-1270
Fax Number : 214-905-9245
Provider Business Practice Location Address
First Line : 1380 RIVER BEND DR
Second Line :
City : DALLAS
State : TX
Zip : 75247-4914
Country : US
Telephone Number : 214-743-1270
Fax Number : 214-905-9245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/08/2007

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