| Martha St. John, M.d., P.a. | |
|
11767 Katy Fwy Suite 364 Houston TX 77079-1716 | |
| (281) 497-3500 | |
| (281) 497-3512 |
| Full Name | Martha St. John, M.d., P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11767 Katy Fwy, Houston, Texas |
| Authorized Official Name and Position | Martha Wolfram St. John (OWNER) |
| Authorized Official Contact | 2814973500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martha St. John, M.d., P.a. 11767 Katy Fwy Suite 364 Houston TX 77079-1716 Ph: (281) 497-3500 | Martha St. John, M.d., P.a. 11767 Katy Fwy Suite 364 Houston TX 77079-1716 Ph: (281) 497-3500 |
| NPI Number | 1134220650 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 07/14/2011 |
| Medicare PECOS PAC ID | 6002918273 |
|---|---|
| Medicare Enrollment ID | O20070220000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134220650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | L9500 (Texas) | Primary |
| Provider Name | Martha W St John |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073534921 PECOS PAC ID: 3173625340 Enrollment ID: I20070220000177 |
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