Healthcare Provider Details

I. General information

NPI: 1942118963
Provider Name (Legal Business Name): MONIQUE ELIZABETH MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 PROFESSIONAL PARK DR STE A
WEBSTER TX
77598-4144
US

IV. Provider business mailing address

9 PROFESSIONAL PARK DR STE A
WEBSTER TX
77598-4144
US

V. Phone/Fax

Practice location:
  • Phone: 832-240-4563
  • Fax:
Mailing address:
  • Phone: 832-240-4563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: