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General NPI Number Information
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NPI Number | 1336315977
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Entity Type | Organization
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Legal Business Name | MARTIN & WILLARD, LLC
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Dates
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Enumeration Date | 05/04/2008
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Last Update Date | 05/04/2008
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Provider Practice Location Address
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Address Line | 14019 SOUTHWEST FWY STE 301-438
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City | SUGAR LAND
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State | TX
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Zip | 77478-3563
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Country | US
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Telephone | 281-565-0955
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Fax | 281-565-0956
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Provider Business Mailing Address
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Address Line | 14019 SOUTHWEST FWY STE 301-438
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City | SUGAR LAND
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State | TX
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Zip | 77478-3563
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Country | US
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Telephone | 281-565-0955
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Fax | 281-565-0956
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Authorized Official
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Title or Position | CEO- PHYSICIAN ASSISTANT
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Name | MRS. WENDI CHERYL STEWART
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Credential | P.A.-C
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Telephone | 281-565-0955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8J2175
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License Number State | TX
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