Organization
MARTIN NEUROBEHAVIORAL CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN KELLY MARTIN PH.D. (OWNER)
(903) 258-9938
Entity
Organization
Contact information
Practice address
3800 PALUXY DR, SUITE 450, TYLER, TX 75703-1629
(903) 258-9938
Mailing address
PO BOX 132381, TYLER, TX 75713-2381
(903) 258-9938
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4740
TX
Other
Enumeration date
08/21/2009
Last updated
10/26/2009
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