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General NPI Number Information
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NPI Number | 1598650012
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Entity Type | Organization
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Legal Business Name | MELISA MARTINEZ THERAPEUTIC SERVICES PLLC
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 24345 WILDERNESS OAK APT 1108
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City | SAN ANTONIO
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State | TX
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Zip | 78258-7878
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Country | US
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Telephone | 806-316-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 300 DECKER DR STE 360
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City | IRVING
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State | TX
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Zip | 75062-8189
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Country | US
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Telephone | 806-316-0111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MELISA DAWN MARTINEZ
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Credential | LCSW
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Telephone | 803-316-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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