Provider Demographics
NPI:1316504236
Name:MARTIN, ALEXANDER CHARLES (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:CHARLES
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1405 RED CLOVER AVE
Mailing Address - Street 2:
Mailing Address - City:VAN ALSTYNE
Mailing Address - State:TX
Mailing Address - Zip Code:75495-4509
Mailing Address - Country:US
Mailing Address - Phone:936-499-8340
Mailing Address - Fax:
Practice Address - Street 1:4501 MEDICAL CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-6942
Practice Address - Country:US
Practice Address - Phone:972-548-8195
Practice Address - Fax:469-247-0032
Is Sole Proprietor?:No
Enumeration Date:2019-05-27
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXV1545208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology