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General NPI Number Information
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NPI Number | 1083519284
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Entity Type | Individual
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Provider Name | MARTHA CRISTINA FAUSNAUGH
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Gender | Female
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 1001 NORTH EL PASO ST
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City | EL PASO
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State | TX
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Zip | 79902
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Country | US
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Telephone | 915-831-4017
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Fax |
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Provider Business Mailing Address
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Address Line | 10348 BLACKWOOD AVE
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City | EL PASO
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State | TX
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Zip | 79925-4352
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Country | US
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Telephone | 915-801-6011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41767
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 27593
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License Number State | TX
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