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NPI Code Detail

MEDICARE: NICOLE JOLENE MARTINEZ PT

MEDICARE: NICOLE JOLENE MARTINEZ PT
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
1225100000XPhysical Therapist1134757TX

General Provider Information

NPI Number : 1366792459
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE JOLENE MARTINEZ PT
Provider Business Mailing Address
First Line : 1693 NIAGARA BLVD
Second Line :
City : LEWISVILLE
State : TX
Zip : 75077-2463
Country : US
Telephone Number : 972-317-5269
Fax Number :
Provider Business Practice Location Address
First Line : 5521 VILLAGE CREEK DR
Second Line :
City : PLANO
State : TX
Zip : 75093-4829
Country : US
Telephone Number : 972-447-0038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2012
Last Update Date : 09/15/2012

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Directions to “ NICOLE JOLENE MARTINEZ PT” Practice Location

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