Individual
MS. CORAZON MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1708 ELMEN ST, HOUSTON, TX 77019-5702
(281) 543-9458
Mailing address
5815 AVENUE A, ROSHARON, TX 77583-7107
(281) 543-9458
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02308
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467678250
BLUE CROSS BLUE SHIELD
TX
05
—
1467678250
—
TX
05
—
286580001
—
TX
Enumeration date
04/18/2007
Last updated
03/26/2015
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