NPI 1003269440

Jerry Martinez, COTA

Practitioner Contractor Alton, TX

Practice location

Address: 921 E Main Ave STE 5, Alton, TX 78573-1606
Phone: (956) 519-2500

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 209135 (TX)

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Registry record

NPI: 1003269440
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Jul 2016
Record last updated: 21 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.