Healthcare Provider Details

I. General information

NPI: 1457978793
Provider Name (Legal Business Name): ALICIA ERI MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2020
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 OLD SAN ANTONIO RD STE 201
BUDA TX
78610-5489
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 737-770-5988
  • Fax: 737-770-5989
Mailing address:
  • Phone: 423-238-7217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1408763
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: