Provider Demographics
NPI:1598805673
Name:MARTIN, ROBYN WINDHAM
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:WINDHAM
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 DARTMOUTH ST APT 526
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-4692
Mailing Address - Country:US
Mailing Address - Phone:979-764-2794
Mailing Address - Fax:
Practice Address - Street 1:1318 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-5215
Practice Address - Country:US
Practice Address - Phone:979-776-6266
Practice Address - Fax:979-776-1456
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102889235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist