Individual
DR. REG C MARTIN
Active
Individual
DR. REG C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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