Provider Demographics
NPI:1255583415
Name:MARTINEZ, ALMA CECILIA (MOT,OTR)
Entity type:Individual
Prefix:MRS
First Name:ALMA
Middle Name:CECILIA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MOT,OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 SPRINGFIELD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6712
Mailing Address - Country:US
Mailing Address - Phone:956-725-4555
Mailing Address - Fax:956-725-3555
Practice Address - Street 1:6550 SPRINGFIELD AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6712
Practice Address - Country:US
Practice Address - Phone:956-725-4555
Practice Address - Fax:956-725-3555
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112717225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203651903Medicaid