Provider Demographics
NPI:1083763437
Name:MARTZ, MICHELLE (DC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MARTZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 HIGHLAND VILLAGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7188
Mailing Address - Country:US
Mailing Address - Phone:972-317-9355
Mailing Address - Fax:972-317-3366
Practice Address - Street 1:2250 HIGHLAND VILLAGE RD STE 200
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7188
Practice Address - Country:US
Practice Address - Phone:972-317-9355
Practice Address - Fax:972-317-3366
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6232111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU44998Medicare ID - Type Unspecified
TX44998Medicare UPIN