Provider Demographics
NPI:1851532444
Name:DIXON, MARTHA S (PA)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:S
Last Name:DIXON
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4057 RILEY FUZZEL RD STE 1100A
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4632
Mailing Address - Country:US
Mailing Address - Phone:281-602-0440
Mailing Address - Fax:281-602-0445
Practice Address - Street 1:4057 RILEY FUZZEL RD STE 1100A
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4632
Practice Address - Country:US
Practice Address - Phone:281-615-1696
Practice Address - Fax:816-020-4452
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2024-09-16
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L15987Medicare PIN