Provider Demographics
NPI:1649050154
Name:MARTIN, JAMES (CTRS, MHA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:MARTIN
Suffix:
Gender:M
Credentials:CTRS, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 GREENHOUSE RD APT 3202
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7823
Mailing Address - Country:US
Mailing Address - Phone:601-331-5491
Mailing Address - Fax:
Practice Address - Street 1:24044 CINCO VILLAGE CENTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8433
Practice Address - Country:US
Practice Address - Phone:713-744-1243
Practice Address - Fax:713-744-1243
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS81644225800000X
TX81644225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist