Provider Demographics
NPI:1770473670
Name:LUJAN, MARTHA G (CHWI-CHW-MHPSS-PSS)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:G
Last Name:LUJAN
Suffix:
Gender:F
Credentials:CHWI-CHW-MHPSS-PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 ARROWMOUND PASS # 11500
Mailing Address - Street 2:
Mailing Address - City:DEL VALLE
Mailing Address - State:TX
Mailing Address - Zip Code:78617-3607
Mailing Address - Country:US
Mailing Address - Phone:512-740-4801
Mailing Address - Fax:
Practice Address - Street 1:11500 ARROWMOUND PASS # 11500
Practice Address - Street 2:
Practice Address - City:DEL VALLE
Practice Address - State:TX
Practice Address - Zip Code:78617-3607
Practice Address - Country:US
Practice Address - Phone:512-740-4801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX175T00000X
TX1096172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer Specialist