Basic Information
| Provider Information | |||||||||
| NPI: | 1689132599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOTARI | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | KEMUNTO | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | I | ||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7301 MARSLAND LN | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760017385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8178197578 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1881 SYLVAN AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752082031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143300036 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2019 | ||||||||
| LastUpdateDate: | 08/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | AP139966 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.