Provider Demographics
NPI:1437330537
Name:MARTINEZ, PATRICIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 E LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-5710
Mailing Address - Country:US
Mailing Address - Phone:817-360-6844
Mailing Address - Fax:817-303-0685
Practice Address - Street 1:817 W PARK ROW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-3904
Practice Address - Country:US
Practice Address - Phone:817-504-7184
Practice Address - Fax:817-961-1880
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17222OtherLICENSE NUMBER