Provider Demographics
NPI:1164869285
Name:MARTINEZ-COLON, LAURA (ACNS-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MARTINEZ-COLON
Suffix:
Gender:F
Credentials:ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9715 BURNET RD
Mailing Address - Street 2:STE. 200, BLDG 7
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5215
Mailing Address - Country:US
Mailing Address - Phone:512-334-2866
Mailing Address - Fax:512-334-2702
Practice Address - Street 1:9715 BURNET RD
Practice Address - Street 2:STE. 200, BLDG 7
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5215
Practice Address - Country:US
Practice Address - Phone:512-334-2866
Practice Address - Fax:512-334-2702
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN 612833364SA2200X
TXAP122945363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX290373YN57Medicare PIN
TX290373YN56Medicare PIN