Provider Demographics
NPI:1659435626
Name:MARTIN, PARUL V (MD)
Entity Type:Individual
Prefix:
First Name:PARUL
Middle Name:V
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PARUL
Other - Middle Name:V
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 99213
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0213
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:10601 N RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-2118
Practice Address - Country:US
Practice Address - Phone:817-347-2600
Practice Address - Fax:817-347-2670
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4428208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080626701Medicaid
TX170994101Medicaid
TX138854OtherSUPERIOR PIN
TX181055802Medicaid
TX2694381OtherUHC PIN
1003887985OtherGRP NPI NUMBER
TX181055801Medicaid
TX163314101Medicaid
TX170994101Medicaid