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NPI Code Detail

MEDICARE: ANNA MARTIN CTRS

MEDICARE: ANNA MARTIN CTRS
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
1225800000XRecreation Therapist46501TX

General Provider Information

NPI Number : 1669048203
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA MARTIN CTRS
Provider Business Mailing Address
First Line : 4500 S LANCASTER RD
Second Line :
City : DALLAS
State : TX
Zip : 75216-7167
Country : US
Telephone Number : 214-742-8387
Fax Number :
Provider Business Practice Location Address
First Line : 101 NEW YORK AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-1558
Country : US
Telephone Number : 469-316-0622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2021
Last Update Date : 06/03/2021

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Directions to “ ANNA MARTIN CTRS” Practice Location

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