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General NPI Number Information
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NPI Number | 1689646978
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Entity Type | Organization
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Legal Business Name | MARTHA A WALTON MD PA
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 755 S WASHINGTON
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City | FREDERICKSBURG
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State | TX
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Zip | 78624
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Country | US
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Telephone | 830-997-6535
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Fax | 830-997-9695
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Provider Business Mailing Address
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Address Line | 755 S WASHINGTON
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City | FREDERICKSBURG
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State | TX
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Zip | 78624
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Country | US
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Telephone | 830-997-6535
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Fax | 830-997-9695
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Authorized Official
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Title or Position | OWNER
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Name | MARTHA A WALTON
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Credential | MD
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Telephone | 830-997-6535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | H1237
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License Number State | TX
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