MEDICARE: MRS. CORYFRANCIS LEE MARTINEZ MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	114072	TX

General Provider Information

NPI Number	:	1043980220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CORYFRANCIS LEE MARTINEZ MS, CCC-SLP

Provider Business Mailing Address
First Line	:	3730 RODD FIELD RD
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-5511
Country	:	US
Telephone Number	:	361-878-2980
Fax Number	:

Provider Business Practice Location Address
First Line	:	3730 RODD FIELD RD
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-5511
Country	:	US
Telephone Number	:	361-878-2980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	09/17/2021

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