Provider Demographics
NPI:1760823173
Name:ZAIDI, MARTHA ALI (PA)
Entity type:Individual
Prefix:MISS
First Name:MARTHA
Middle Name:ALI
Last Name:ZAIDI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:LEE
Other - Last Name:SOSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:225 BELLA KATY DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6821
Mailing Address - Country:US
Mailing Address - Phone:832-500-7585
Mailing Address - Fax:832-514-2763
Practice Address - Street 1:225 BELLA KATY DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6821
Practice Address - Country:US
Practice Address - Phone:832-500-7585
Practice Address - Fax:832-514-2763
Is Sole Proprietor?:No
Enumeration Date:2013-07-13
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08393363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX338294YXEWMedicare PIN