Healthcare Provider Details

I. General information

NPI: 1912836107
Provider Name (Legal Business Name): AYLIN AYDITH MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 S CANYON ST
CARLSBAD NM
88220-5733
US

IV. Provider business mailing address

1818 AMAZON DR
CORPUS CHRISTI TX
78412-5004
US

V. Phone/Fax

Practice location:
  • Phone: 575-437-3351
  • Fax:
Mailing address:
  • Phone: 361-429-1631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2183708
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: