Provider Demographics
NPI:1902856339
Name:MCQUAID, MARTHA L (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:L
Last Name:MCQUAID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 W 15TH ST
Mailing Address - Street 2:BLDG. C
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-4737
Mailing Address - Country:US
Mailing Address - Phone:972-596-4033
Mailing Address - Fax:972-758-1163
Practice Address - Street 1:8401 JACK FINNEY BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-3017
Practice Address - Country:US
Practice Address - Phone:800-945-2455
Practice Address - Fax:800-945-2455
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4343174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG32601Medicare UPIN
TX8C0969Medicare PIN
TX8C0968Medicare PIN
TXP00146351Medicare PIN