Provider Demographics
NPI:1962166652
Name:MARTINEZ, URSULA ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:URSULA
Middle Name:ANN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 THOMASON AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-6144
Mailing Address - Country:US
Mailing Address - Phone:915-230-2839
Mailing Address - Fax:915-230-0825
Practice Address - Street 1:3700 THOMASON AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-6144
Practice Address - Country:US
Practice Address - Phone:915-230-2839
Practice Address - Fax:915-230-0825
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101895235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist