Provider Demographics
NPI:1760046502
Name:MARTEZ PLACE HCS LLC
Entity Type:Organization
Organization Name:MARTEZ PLACE HCS LLC
Other - Org Name:MARTEZ PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARLO
Authorized Official - Middle Name:
Authorized Official - Last Name:SNERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-586-7110
Mailing Address - Street 1:2126 PECAN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-4070
Mailing Address - Country:US
Mailing Address - Phone:214-586-7110
Mailing Address - Fax:
Practice Address - Street 1:2126 PECAN RIDGE DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-4070
Practice Address - Country:US
Practice Address - Phone:214-586-7110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX834551325Medicaid