Healthcare Provider Details

I. General information

NPI: 1659524841
Provider Name (Legal Business Name): MARSHA DENISE MARTIN HOMEHEALTH AID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 STH. FIELDER RD #5
ARLINGTON TX
76013-1785
US

IV. Provider business mailing address

PO BOX 181358
ARLINGTON TX
76096-1358
US

V. Phone/Fax

Practice location:
  • Phone: 817-404-8825
  • Fax:
Mailing address:
  • Phone: 817-404-8825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberNA00842666
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA00842666
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: