MEDICARE: MRS. TAMMIE YVETTE MARTIN

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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1538526124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMMIE YVETTE MARTIN

Provider Business Mailing Address
First Line	:	7834 OAKINGTON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2119
Country	:	US
Telephone Number	:	281-415-7030
Fax Number	:	888-745-5165

Provider Business Practice Location Address
First Line	:	7834 OAKINGTON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2119
Country	:	US
Telephone Number	:	281-415-7030
Fax Number	:	888-745-5165

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2016
Last Update Date	:	01/27/2016

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