| Martin Neurobehavioral Center, Pc | |
|
3800 Paluxy Dr Suite 450 Tyler TX 75703-1629 | |
| (903) 258-9938 | |
| Not Available |
| Full Name | Martin Neurobehavioral Center, Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3800 Paluxy Dr, Tyler, Texas |
| Authorized Official Name and Position | Stephen Kelly Martin (OWNER) |
| Authorized Official Contact | 9032589938 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin Neurobehavioral Center, Pc Po Box 132381 Tyler TX 75713-2381 Ph: (903) 258-9938 | Martin Neurobehavioral Center, Pc 3800 Paluxy Dr Suite 450 Tyler TX 75703-1629 Ph: (903) 258-9938 |
| NPI Number | 1356573414 |
|---|---|
| Provider Enumeration Date | 08/21/2009 |
| Last Update Date | 10/26/2009 |
| Medicare PECOS PAC ID | 6305982562 |
|---|---|
| Medicare Enrollment ID | O20091001000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356573414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 4740 (Texas) | Primary |
| Provider Name | Stephen K Martin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144233297 PECOS PAC ID: 6901813757 Enrollment ID: I20060320000347 |
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