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General NPI Number Information
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NPI Number | 1942950183
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Entity Type | Organization
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Legal Business Name | TXURSELFMD
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 1690 MEADE ST
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City | DENVER
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State | CO
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Zip | 80204-1552
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Country | US
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Telephone | 702-453-3379
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Fax | 702-453-5741
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Provider Business Mailing Address
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Address Line | 405 E WETMORE RD STE 117 # 230
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City | TUCSON
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State | AZ
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Zip | 85705-1792
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Authorized Official
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Title or Position | SOLE OWNER
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Name | ERIC MARTIN
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Credential | M.D.
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Telephone | 702-453-3799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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