Provider Demographics
NPI:1346404001
Name:MARTIN, PATRICK WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:WILLIAM
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-793-1188
Mailing Address - Fax:405-793-0492
Practice Address - Street 1:571 W MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3667
Practice Address - Country:US
Practice Address - Phone:972-436-9785
Practice Address - Fax:972-436-6068
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS4344207Q00000X
OK26324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine