Provider Demographics
NPI:1699191320
Name:MARTINO, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MARTINO
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 1:4000 WASHINGTON AVE
Mailing Address - Street 2:302
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5673
Mailing Address - Country:US
Mailing Address - Phone:713-861-2722
Mailing Address - Fax:
Practice Address - Street 1:4000 WASHINGTON AVE
Practice Address - Street 2:302
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5673
Practice Address - Country:US
Practice Address - Phone:713-861-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1240048225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist