Healthcare Provider Details

I. General information

NPI: 1346132156
Provider Name (Legal Business Name): ESTEBAN RAFAEL MARTINEZ-CABELLO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9010 N LAKE CREEK PKWY BLDG 2
AUSTIN TX
78717-6217
US

IV. Provider business mailing address

9010 N LAKE CREEK PKWY BLDG 2
AUSTIN TX
78717-6217
US

V. Phone/Fax

Practice location:
  • Phone: 737-707-6737
  • Fax:
Mailing address:
  • Phone: 737-707-6737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number1321924
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: