Provider Demographics
NPI:1932072824
Name:BETANCOURT MARTINEZ, EILEEN (SLP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:BETANCOURT MARTINEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10715 GULFDALE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3632
Mailing Address - Country:US
Mailing Address - Phone:830-570-4492
Mailing Address - Fax:210-568-4937
Practice Address - Street 1:10715 GULFDALE ST STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3632
Practice Address - Country:US
Practice Address - Phone:830-570-4492
Practice Address - Fax:210-568-4937
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11962235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist