Provider Demographics
NPI:1679753826
Name:MBOE, MARTIN NJUME (RN)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:NJUME
Last Name:MBOE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 BIG BEND LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3510
Mailing Address - Country:US
Mailing Address - Phone:469-438-3293
Mailing Address - Fax:
Practice Address - Street 1:6800 BIG BEND LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-3510
Practice Address - Country:US
Practice Address - Phone:469-438-3293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743983163W00000X
TX1122645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse