Individual
C MARTIN PERSONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4625 BOAT CLUB RD, SUITE 253, FORT WORTH, TX 76135-7022
(817) 399-1622
(817) 540-0759
Mailing address
4625 BOAT CLUB RD, SUITE 253, FORT WORTH, TX 76135-7022
(817) 399-1622
(817) 540-0759
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
F4368
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114261403
—
TX
01
—
4080053
AETNA
TX
01
—
MDF4368
WORKERS COMP
TX
Enumeration date
08/15/2005
Last updated
10/11/2013
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