Provider Demographics
NPI:1437318862
Name:MARTINEZ, GRISELDA C (PT)
Entity Type:Individual
Prefix:
First Name:GRISELDA
Middle Name:C
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4610 E SOUTHCROSS BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-4914
Mailing Address - Country:US
Mailing Address - Phone:210-359-6186
Mailing Address - Fax:210-359-0223
Practice Address - Street 1:4610 E SOUTHCROSS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-4914
Practice Address - Country:US
Practice Address - Phone:210-359-6186
Practice Address - Fax:210-359-0223
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1175930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist