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General NPI Number Information
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NPI Number | 1356751267
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Entity Type | Individual
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Provider Name | VALERIE ELISE MARTEN-ELLIS O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 2301 S CLEAR CREEK RD SUITE 116
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City | KILLEEN
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State | TX
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Zip | 76549-4143
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Country | US
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Telephone | 254-526-5505
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Fax | 254-526-4313
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Provider Business Mailing Address
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Address Line | 2301 S CLEAR CREEK RD SUITE 116
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City | KILLEEN
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State | TX
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Zip | 76549-4143
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Country | US
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Telephone | 254-526-5505
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Fax | 254-526-4313
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8369TG
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License Number State | TX
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