Individual
SOPHIA MARIA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD
Contact information
Practice address
6104 AVENUE Q, LUBBOCK, TX 79412-3506
(806) 472-3400
Mailing address
2829 23RD ST, LUBBOCK, TX 79410-1627
(575) 499-8460
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT85223
TX
133V00000X
Registered Dietitian
LD-1205
NM
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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