Provider Demographics
NPI:1598139974
Name:MARTIN, MONICA (PT, DPT, C/NDT)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PT, DPT, C/NDT
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:CHAMBERLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8711 DAKOTA CRK
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-4632
Mailing Address - Country:US
Mailing Address - Phone:210-313-9816
Mailing Address - Fax:
Practice Address - Street 1:8711 DAKOTA CRK
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-4632
Practice Address - Country:US
Practice Address - Phone:210-313-9816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist