Provider Demographics
NPI:1841758828
Name:MARTIN, CLAUDIS ANDREW (FNP)
Entity Type:Individual
Prefix:MR
First Name:CLAUDIS
Middle Name:ANDREW
Last Name:MARTIN
Suffix:
Gender:M
Credentials:FNP
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Mailing Address - Street 1:15197 MOONLIGHT TRL
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3543
Mailing Address - Country:US
Mailing Address - Phone:832-263-1300
Mailing Address - Fax:832-909-0113
Practice Address - Street 1:15197 MOONLIGHT TRL
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3543
Practice Address - Country:US
Practice Address - Phone:832-263-1300
Practice Address - Fax:832-909-0113
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty