Provider Demographics
NPI:1497552012
Name:DAVILA, MARTHA E (LMFT-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:E
Last Name:DAVILA
Suffix:
Gender:
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8011 N NEW BRAUNFELS AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2768
Mailing Address - Country:US
Mailing Address - Phone:210-891-7376
Mailing Address - Fax:
Practice Address - Street 1:14893 BANDERA RD STE 5A
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-3879
Practice Address - Country:US
Practice Address - Phone:210-376-8292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty