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NPI Code Detail

MEDICARE: MR. RAYMOND MARTINEZ LCSW

MEDICARE:  MR. RAYMOND  MARTINEZ  LCSW
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
11041C0700XClinical Social Worker62762TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
162762OTHERTXTSBSWE

General Provider Information

NPI Number : 1518576248
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAYMOND MARTINEZ LCSW
Provider Business Mailing Address
First Line : 1300 S UNIVERSITY DR STE 306
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5746
Country : US
Telephone Number : 844-824-8775
Fax Number :
Provider Business Practice Location Address
First Line : 1300 S UNIVERSITY DR STE 306
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5746
Country : US
Telephone Number : 844-824-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2020
Last Update Date : 04/22/2026

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Directions to “ MR. RAYMOND MARTINEZ LCSW” Practice Location

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