Provider Demographics
NPI:1043505753
Name:MARTINEZ, DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6448 E HWY 290 STE D105
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1040
Mailing Address - Country:US
Mailing Address - Phone:512-549-6100
Mailing Address - Fax:512-549-6101
Practice Address - Street 1:6448 E HWY 290 STE D105
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1040
Practice Address - Country:US
Practice Address - Phone:512-549-6100
Practice Address - Fax:512-549-6101
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor