Physician Compare National (NPI:1154416600)

HEALTHCARE PROVIDER: MARTHA PAULINE WILLS M.D., F.A.C.S., P.A.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1154416600
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9537185178
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110609000165
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILLS
	Individual professional last name
Provider First Name	MARTHA
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4375 BOOTH CALLOWAY RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 507
	Group Practice or individual's line 2 address
City	NORTH RICHLAND HILLS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	761808368
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450087
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEDICAL CITY NORTH HILLS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450271
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WISE REGIONAL HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	670085
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	670103
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MEDICAL CITY ALLIANCE
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y