Provider Demographics
NPI:1285607788
Name:CHINNERY, MARTHA STEELE (MD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:STEELE
Last Name:CHINNERY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3533 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1721
Mailing Address - Country:US
Mailing Address - Phone:361-694-5240
Mailing Address - Fax:361-694-4080
Practice Address - Street 1:3533 S ALAMEDA ST
Practice Address - Street 2:CPSST, 5TH FLOOR SLOAN BLDG, RADIOLOGY
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1721
Practice Address - Country:US
Practice Address - Phone:361-694-5240
Practice Address - Fax:361-694-4080
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG20652085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1036592-04Medicaid
H26552Medicare UPIN
TX1036592-04Medicaid