Provider Demographics
NPI:1609817741
Name:STRITTMATTER, MARLA ANN (MD)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:ANN
Last Name:STRITTMATTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409N ELM ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3089
Mailing Address - Country:US
Mailing Address - Phone:940-387-6387
Mailing Address - Fax:940-387-6377
Practice Address - Street 1:1409N ELM ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3089
Practice Address - Country:US
Practice Address - Phone:940-387-6387
Practice Address - Fax:940-387-6377
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080191739OtherRAILROAD MEDICARE
TX037114802Medicaid
TX037114803OtherMEDICAID OTHER
TX8A2015Medicare PIN
TX037114803OtherMEDICAID OTHER