Provider Demographics
NPI:1376155226
Name:FORT BEND CORRECTIVE MEDICINE PLLC
Entity Type:Organization
Organization Name:FORT BEND CORRECTIVE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-261-7200
Mailing Address - Street 1:5201 HIGHWAY 6 STE 800
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4379
Mailing Address - Country:US
Mailing Address - Phone:281-261-7200
Mailing Address - Fax:281-261-7220
Practice Address - Street 1:5201 HIGHWAY 6 STE 800
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4379
Practice Address - Country:US
Practice Address - Phone:281-261-7200
Practice Address - Fax:281-261-7220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty