Individual
DAVID R MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 WESTPARK WAY, SUITE B, EULESS, TX 76040-3972
(817) 283-5166
(817) 283-5176
Mailing address
3801 WILLIAM D TATE AVE, STE 105, GRAPEVINE, TX 76051-8755
(817) 488-6812
(817) 251-1303
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
L3389
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150569507
—
TX
05
—
150569509
—
TX
01
—
207735
PACIFICARE
TX
01
—
7617368
AETNA
TX
01
—
8CE650
BCBS TX
—
01
—
P000789478
RAILROAD MEDICARE
—
Enumeration date
03/18/2006
Last updated
09/23/2019
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