Provider Demographics
NPI:1982954376
Name:MARTIN, DAVID EUGENE (FNP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:EUGENE
Last Name:MARTIN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 STONECREST PATH
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-9414
Mailing Address - Country:US
Mailing Address - Phone:830-627-1216
Mailing Address - Fax:
Practice Address - Street 1:2145 STONECREST PATH
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-9414
Practice Address - Country:US
Practice Address - Phone:830-627-1216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX714309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily