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General NPI Number Information
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NPI Number | 1518394923
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Entity Type | Individual
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Provider Name | COURTNEY LEIGH MARTINEZ AG-ACNP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2013
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 22999 HIGHWAY 59 N
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City | KINGWOOD
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State | TX
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Zip | 77339-4412
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Country | US
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Telephone | 281-348-8246
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Fax |
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Provider Business Mailing Address
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Address Line | 21398 W MARTIN DR
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City | PORTER
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State | TX
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Zip | 77365-4601
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Country | US
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Telephone | 713-542-8791
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 717049
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License Number State | TX
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