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General NPI Number Information
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NPI Number | 1487451506
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL MARTINEZ
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Gender | Male
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 5800 BERKMAN DR
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City | AUSTIN
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State | TX
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Zip | 78723-2625
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Country | US
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Telephone | 512-829-8738
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 E M FRANKLIN AVE UNIT 1
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City | AUSTIN
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State | TX
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Zip | 78721-1124
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Country | US
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Telephone | 832-330-9852
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 108850
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License Number State | TX
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