Provider Demographics
NPI:1558653782
Name:CORONA MARTINEZ, HIRAM JAIR (OTR/L)
Entity Type:Individual
Prefix:
First Name:HIRAM
Middle Name:JAIR
Last Name:CORONA MARTINEZ
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:HIRAM
Other - Middle Name:JAIR
Other - Last Name:CORONA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 17411
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-0411
Mailing Address - Country:US
Mailing Address - Phone:210-390-1795
Mailing Address - Fax:
Practice Address - Street 1:327 W. SUNSET RD #1303
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209
Practice Address - Country:US
Practice Address - Phone:210-390-1795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120037225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics