Provider Demographics
NPI:1417635103
Name:MARTIN EYE PLLC
Entity Type:Organization
Organization Name:MARTIN EYE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:REYGAN
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-430-9147
Mailing Address - Street 1:5754 KYLE PKWY
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2404
Mailing Address - Country:US
Mailing Address - Phone:580-430-9147
Mailing Address - Fax:
Practice Address - Street 1:5754 KYLE PKWY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2404
Practice Address - Country:US
Practice Address - Phone:580-430-9147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty