Provider Demographics
NPI:1417486390
Name:FENSTERMACHER, MARTINE KAY (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:MARTINE
Middle Name:KAY
Last Name:FENSTERMACHER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14140 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3842
Mailing Address - Country:US
Mailing Address - Phone:281-649-7000
Mailing Address - Fax:281-240-0030
Practice Address - Street 1:22999 HIGHWAY 59 N STE 400
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-358-2314
Practice Address - Fax:281-358-2357
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
TX80973231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist