Provider Demographics
NPI:1497853501
Name:ADAMS, MARTHA L (SLP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:L
Last Name:ADAMS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 BEE CAVE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5675
Mailing Address - Country:US
Mailing Address - Phone:512-284-8964
Mailing Address - Fax:512-284-8966
Practice Address - Street 1:2700 BEE CAVE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5675
Practice Address - Country:US
Practice Address - Phone:512-284-8964
Practice Address - Fax:512-284-8966
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16002235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16002OtherSTATE BOARD
TX89043TOtherBLUE CROSS BLUE SHIELD