Provider Demographics
NPI:1407256076
Name:SULE, MARTIN BAYODE (FNP)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:BAYODE
Last Name:SULE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:MR
Other - First Name:MARTIN
Other - Middle Name:BAYODE
Other - Last Name:SULE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:6400 FANNIN ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1521
Mailing Address - Country:US
Mailing Address - Phone:832-325-7211
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:SUITE 600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:832-325-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR183795363LF0000X
TXAP127560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily