Provider Demographics
NPI:1376608265
Name:STORRIE, MARTHA CECILE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:CECILE
Last Name:STORRIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3315 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6884
Mailing Address - Country:US
Mailing Address - Phone:940-320-1708
Mailing Address - Fax:940-565-5457
Practice Address - Street 1:1600 WATERS RIDGE DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-6039
Practice Address - Country:US
Practice Address - Phone:972-219-0558
Practice Address - Fax:972-436-9273
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH1415208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX524354YWSHMedicare PIN
85T212Medicare ID - Type Unspecified
E45991Medicare UPIN