Provider Demographics
NPI:1235110511
Name:YEE, MARTIN W (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:W
Last Name:YEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 UNIVERSITY BLVD
Mailing Address - Street 2:STE 225 PMB 108
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1096
Mailing Address - Country:US
Mailing Address - Phone:254-410-0555
Mailing Address - Fax:
Practice Address - Street 1:750 W CENTRAL TEXAS EXPY,
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548
Practice Address - Country:US
Practice Address - Phone:254-236-6820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT4093208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1497872980Medicaid