Individual
DR. REG C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 S COULTER ST, AMARILLO, TX 79106-1770
(806) 354-1000
Mailing address
801 S FILLMORE ST, SUITE 410, AMARILLO, TX 79101-3537
(806) 355-9595
(806) 353-1589
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
L4053
TX
207L00000X
Anesthesiology Physician
Primary
L4053
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152727701
—
TX
01
—
8F8292
BC/BS
TX
Enumeration date
11/11/2005
Last updated
06/29/2010
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