Healthcare Provider Details

I. General information

NPI: 1326412958
Provider Name (Legal Business Name): VALERIE MARTIN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20639 KUYKENDAHL RD
SPRING TX
77379
US

IV. Provider business mailing address

6767 LAKE WOODLANDS DR
THE WOODLANDS TX
77382-2566
US

V. Phone/Fax

Practice location:
  • Phone: 832-698-0111
  • Fax:
Mailing address:
  • Phone: 281-364-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1300268
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: