Provider Demographics
NPI:1497872980
Name:MARTIN W YEE M D TEAM REHAB PA
Entity Type:Organization
Organization Name:MARTIN W YEE M D TEAM REHAB PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-773-0240
Mailing Address - Street 1:200 UNIVERSITY BLVD
Mailing Address - Street 2:STE 225 PMB 108
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1096
Mailing Address - Country:US
Mailing Address - Phone:254-410-0555
Mailing Address - Fax:
Practice Address - Street 1:750 W CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548
Practice Address - Country:US
Practice Address - Phone:254-236-6820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ33319174400000X
VA0101263828208100000X
208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1497872980Medicaid
AZZ102431Medicare UPIN