Provider Demographics
NPI:1912321704
Name:MARTINEZ, PAUL STEVEN (LPC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:STEVEN
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 PLUM VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2219
Mailing Address - Country:US
Mailing Address - Phone:210-416-6455
Mailing Address - Fax:
Practice Address - Street 1:8800 BROADWAY ST
Practice Address - Street 2:SUITE 8820
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6335
Practice Address - Country:US
Practice Address - Phone:210-826-8686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional