Provider Demographics
NPI:1912789538
Name:MARTINEZ, MARGOT (LPA)
Entity type:Individual
Prefix:
First Name:MARGOT
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2915
Mailing Address - Country:US
Mailing Address - Phone:956-600-7123
Mailing Address - Fax:956-600-7101
Practice Address - Street 1:423 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2915
Practice Address - Country:US
Practice Address - Phone:956-600-7123
Practice Address - Fax:710-195-6600
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39963103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist