Provider Demographics
NPI:1174713754
Name:SANTAMARIA, MARTHA L (ANP)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:L
Last Name:SANTAMARIA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 WADE BLVD STE 1160
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0246
Mailing Address - Country:US
Mailing Address - Phone:469-384-2350
Mailing Address - Fax:469-384-2359
Practice Address - Street 1:8501 WADE BLVD STE 1160
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-0246
Practice Address - Country:US
Practice Address - Phone:469-384-2350
Practice Address - Fax:469-384-2359
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP1088078363LF0000X
TX652804363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K4959Medicare UPIN