Provider Demographics
NPI:1205450392
Name:MARTINEZ, JONATHON CAMDEN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:CAMDEN
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 MORELAND DR APT 74
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7545
Mailing Address - Country:US
Mailing Address - Phone:956-878-2329
Mailing Address - Fax:
Practice Address - Street 1:601 N VERMONT AVE STE 116
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2254
Practice Address - Country:US
Practice Address - Phone:956-520-2685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist