Provider Demographics
NPI:1417174137
Name:MARTIN, BILLIE (DC)
Entity Type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6575 WEST LOOP S
Mailing Address - Street 2:STE. 645
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3521
Mailing Address - Country:US
Mailing Address - Phone:713-664-3353
Mailing Address - Fax:
Practice Address - Street 1:6575 WEST LOOP S
Practice Address - Street 2:STE. 645
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3521
Practice Address - Country:US
Practice Address - Phone:713-664-3353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6168111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition