Provider Demographics
NPI:1992850812
Name:MARTIN, IRMA ANTOINETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:IRMA
Middle Name:ANTOINETTE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9804 VALDERRAMA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-3851
Mailing Address - Country:US
Mailing Address - Phone:512-218-0212
Mailing Address - Fax:512-246-6333
Practice Address - Street 1:9804 VALDERRAMA DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-3851
Practice Address - Country:US
Practice Address - Phone:512-218-0212
Practice Address - Fax:512-246-6333
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8908207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine