Provider Demographics
NPI:1720155120
Name:MARTINO, DAVID (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MARTINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 HIGHWAY 6 STE 800
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4385
Mailing Address - Country:US
Mailing Address - Phone:281-261-7200
Mailing Address - Fax:281-261-7220
Practice Address - Street 1:5201 HIGHWAY 6 STE 800
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4385
Practice Address - Country:US
Practice Address - Phone:281-261-7200
Practice Address - Fax:281-261-7220
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00646800111N00000X
TX10747111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor