Individual
DAISY MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 CALIFORNIA LN, ARLINGTON, TX 76015-1910
(682) 401-4404
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(682) 401-4404
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251B00000X
—
TX
Enumeration date
02/14/2019
Last updated
07/22/2019
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