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NPI Code Detail

MEDICARE: AVA BROOKS MARTINEZ PT

MEDICARE: AVA BROOKS MARTINEZ PT
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
1225100000XPhysical Therapist1083921TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578521597
Entity Type Code : Individual
Provider Name (Legal Business Name) : AVA BROOKS MARTINEZ PT
Provider Business Mailing Address
First Line : 1515 HERITAGE DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75069-3256
Country : US
Telephone Number : 972-562-0190
Fax Number :
Provider Business Practice Location Address
First Line : 1515 HERITAGE DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75069-3256
Country : US
Telephone Number : 972-562-0331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 07/08/2024

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Directions to “ AVA BROOKS MARTINEZ PT” Practice Location

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