Provider Demographics
NPI:1497484265
Name:MARTINEZ, NICOLAS E (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:E
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 BRETT DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1234
Mailing Address - Country:US
Mailing Address - Phone:281-216-5633
Mailing Address - Fax:
Practice Address - Street 1:10602 EMORY QUINN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-4589
Practice Address - Country:US
Practice Address - Phone:281-216-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1336465225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist