Provider Demographics
NPI:1417796509
Name:MARTINEZ, EMILY (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5356 ISAIAS AVALOS LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-3183
Mailing Address - Country:US
Mailing Address - Phone:915-422-9810
Mailing Address - Fax:
Practice Address - Street 1:12430 EDGEMERE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-4576
Practice Address - Country:US
Practice Address - Phone:915-223-6305
Practice Address - Fax:915-975-8110
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1392354225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty