Provider Demographics
NPI:1447076518
Name:GRIMALDO, MARTHA ZARAHI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:ZARAHI
Last Name:GRIMALDO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HILBIG RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1450
Mailing Address - Country:US
Mailing Address - Phone:936-522-4200
Mailing Address - Fax:936-756-9671
Practice Address - Street 1:700 HILBIG RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1450
Practice Address - Country:US
Practice Address - Phone:936-522-4200
Practice Address - Fax:936-756-9671
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1087029363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health