Provider Demographics
NPI:1457720187
Name:MARTINEZ, LINDA MORENO (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MORENO
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 UHLAND RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-6630
Mailing Address - Country:US
Mailing Address - Phone:512-396-0872
Mailing Address - Fax:512-392-1918
Practice Address - Street 1:101 UHLAND RD
Practice Address - Street 2:SUITE 112
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-6630
Practice Address - Country:US
Practice Address - Phone:512-396-0872
Practice Address - Fax:512-392-1918
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110291235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist