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Organization
WAY OUT WEST SPINE AND MOBILITY PLLC
Active
Organization
WAY OUT WEST SPINE AND MOBILITY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MARTINEZ II DO (LEAD PHYSICIAN)
(682) 285-1044
Entity
Organization
Contact information
Practice address
120 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104-1256
(682) 285-1044
(855) 361-0894
Mailing address
120 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104-1256
(682) 285-1044
(855) 361-0894
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
03/14/2019
Last updated
07/26/2022
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