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NPI 1205450392

NPI 1205450392 : JONATHON CAMDEN MARTINEZ PT, DPT : MERCEDES, TX

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General NPI Number Information
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    NPI Number           |    1205450392
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    Entity Type          |    Individual 
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    Provider Name        |    JONATHON CAMDEN MARTINEZ PT, DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/03/2020
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    Last Update Date     |    03/04/2026
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Provider Practice Location Address
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    Address Line         |    601 N VERMONT AVE STE 115 
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    City                 |    MERCEDES
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    State                |    TX
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    Zip                  |    78570-2254
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    Country              |    US
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    Telephone            |    956-520-2685
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    28196 BASS BLVD 
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    City                 |    HARLINGEN
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    State                |    TX
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    Zip                  |    78552-6706
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    Country              |    US
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    Telephone            |    956-878-2329
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    TX
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