Provider Demographics
NPI:1639823081
Name:MARTIN, GILDA (APRN-C)
Entity Type:Individual
Prefix:
First Name:GILDA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E FM 544 STE 72 PMB 347
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4035
Mailing Address - Country:US
Mailing Address - Phone:214-799-3236
Mailing Address - Fax:
Practice Address - Street 1:5600 TENNYSON PKWY STE 345
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4058
Practice Address - Country:US
Practice Address - Phone:469-829-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1061484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily