Doctor Name: | DAVID LEE MARTIN |
NPI Number: | 1912114307 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | H6406 |
Business Practice Address: | 12411 Hymeadow Dr Building 3, Suite A Austin, TX - 787501874 |
Business Phone Number: | 5122582500 |
Business Fax Number: | |
Mailing Address: | 12411 Hymeadow Dr, Building 3, Suite A AUSTIN |
State: | TX |
Postal Code: | 787501874 |
Phone Number: | 5122582500 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 10/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | H6406 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |