Provider Demographics
NPI:1457344780
Name:MARTIN, BILLIE KAREN (PA)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:KAREN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AUSTIN HEART PLLC
Mailing Address - Street 2:PO BOX 402669
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-2669
Mailing Address - Country:US
Mailing Address - Phone:512-206-4300
Mailing Address - Fax:512-206-4350
Practice Address - Street 1:1330 WONDER WORLD DR
Practice Address - Street 2:STE B108
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7566
Practice Address - Country:US
Practice Address - Phone:512-396-5603
Practice Address - Fax:512-396-5623
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00781207RC0000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1961021-01Medicaid
TX1961021-01Medicaid
TX81N055Medicare PIN