Provider Demographics
NPI:1063602001
Name:MARTINEZ, SARAH OLSTYN (DO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:OLSTYN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:OLSTYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5015 WESTFIELD DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5029
Mailing Address - Country:US
Mailing Address - Phone:773-558-9165
Mailing Address - Fax:
Practice Address - Street 1:11113 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5236
Practice Address - Country:US
Practice Address - Phone:512-324-6010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4639207P00000X
IL036118906207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207655601Medicaid
IL036118906Medicaid
TX207655602Medicaid