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Individual
MS. KIMBERLY DIANE MARTIN
Active
Individual
MS. KIMBERLY DIANE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1070845
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134682101
VALLEY HEALTH PLANS
TX
05
—
166501001
—
TX
01
—
204544800
ACS DEPARTMENT OF LABOR
TX
01
—
8T2359
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/28/2006
Last updated
07/14/2021
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