Provider Demographics
NPI:1598561516
Name:MARTENS, AGATHA P (LM,CPM)
Entity type:Individual
Prefix:
First Name:AGATHA
Middle Name:P
Last Name:MARTENS
Suffix:
Gender:
Credentials:LM,CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 495
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:TX
Mailing Address - Zip Code:79360-0495
Mailing Address - Country:US
Mailing Address - Phone:432-788-0307
Mailing Address - Fax:
Practice Address - Street 1:672 CR 304K
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:TX
Practice Address - Zip Code:79360
Practice Address - Country:US
Practice Address - Phone:432-788-0307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99591176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife