Provider Demographics
NPI:1033961644
Name:PADRON CAMACHO, MARTHA NAYELI (NP-BC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:NAYELI
Last Name:PADRON CAMACHO
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:NAYELI
Other - Last Name:PADRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3200 TALON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-9720
Mailing Address - Country:US
Mailing Address - Phone:214-431-4539
Mailing Address - Fax:
Practice Address - Street 1:3200 TALON DR STE 100
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-9720
Practice Address - Country:US
Practice Address - Phone:214-431-4539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1156883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily