MEDICARE: DAVID E MARTIN MD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center
2	208200000X	Plastic Surgery Physician	G5334	TX

General Provider Information

NPI Number	:	1114195104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID E MARTIN MD, PA

Provider Business Mailing Address
First Line	:	7777 FOREST LN STE C625
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-7520
Country	:	US
Telephone Number	:	972-566-6988
Fax Number	:	972-566-6108

Provider Business Practice Location Address
First Line	:	7777 FOREST LN STE C625
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-7520
Country	:	US
Telephone Number	:	972-566-6988
Fax Number	:	972-566-7288

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DAVID EXLINE MARTIN
Credential	:	MD
Telephone Number	:	972-566-6988

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	07/30/2025

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