Provider Demographics
NPI:1265549224
Name:CURBO, MARTY D (APRN, BC, FNP)
Entity type:Individual
Prefix:
First Name:MARTY
Middle Name:D
Last Name:CURBO
Suffix:
Gender:M
Credentials:APRN, BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 MEADOWLAND DR
Mailing Address - Street 2:
Mailing Address - City:MC GREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657-9728
Mailing Address - Country:US
Mailing Address - Phone:254-848-5607
Mailing Address - Fax:
Practice Address - Street 1:4800 LAKEWOOD DR STE 5
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-2965
Practice Address - Country:US
Practice Address - Phone:254-772-7037
Practice Address - Fax:254-776-7188
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500142163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121405806Medicaid
8D2413Medicare ID - Type Unspecified
TX121405806Medicaid