Provider Demographics
NPI:1760923312
Name:MARTINEZ, ASHLEY RENEE (MAT, ATC,LAT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MAT, ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 S PADRE ISLAND DR
Mailing Address - Street 2:1917
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-5238
Mailing Address - Country:US
Mailing Address - Phone:830-734-0155
Mailing Address - Fax:
Practice Address - Street 1:6300 OCEAN DR
Practice Address - Street 2:UNIT 5719
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-5503
Practice Address - Country:US
Practice Address - Phone:361-825-3745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT62672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer