Provider Demographics
NPI:1073877056
Name:MARTINEZ, DANIEL A (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
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 1:2205 ANITA DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1332
Mailing Address - Country:US
Mailing Address - Phone:214-385-9881
Mailing Address - Fax:
Practice Address - Street 1:2618 ELECTRONIC LN
Practice Address - Street 2:SUITE 102
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-1216
Practice Address - Country:US
Practice Address - Phone:214-385-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10599111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology