Provider Demographics
NPI:1821169996
Name:MARTINEZ, LAURA O'DOWD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:O'DOWD
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LYNNE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8828 N STEMMONS FWY
Mailing Address - Street 2:#225
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3719
Mailing Address - Country:US
Mailing Address - Phone:214-552-8357
Mailing Address - Fax:
Practice Address - Street 1:2921 MASTERS CIR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3405
Practice Address - Country:US
Practice Address - Phone:214-552-8357
Practice Address - Fax:972-403-7608
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32144103TC0700X, 103T00000X
TX32458103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166560601Medicaid
TX425752YRK5OtherMEDICARE
TX89441AOtherBLUE CROSS BLUE SHIELD
TX166560603Medicaid
TX166560604OtherMEDICAID CSHCN
TX166560604OtherMEDICAID CSHCN