Healthcare Provider Details

I. General information

NPI: 1326417239
Provider Name (Legal Business Name): MARTHA MILAM SARINANA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHA MILAM

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11410 JOLLYVILLE RD STE 1101
AUSTIN TX
78759-4093
US

IV. Provider business mailing address

8240 N MOPAC EXPY STE 100
AUSTIN TX
78759-8869
US

V. Phone/Fax

Practice location:
  • Phone: 512-512-2311
  • Fax: 512-231-7051
Mailing address:
  • Phone: 512-687-1970
  • Fax: 512-407-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA10230
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: