Individual
BILLY RAY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360
(318) 466-4000
Mailing address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 466-4000
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1733
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1733
THE STATE OF TEXAS
TX
01
—
182193601
AMERIGROUP
TX
05
—
182193601
—
TX
01
—
8V9341
BLUE CROSS
TX
01
—
P00344116
RAILROAD MEDICARE
TX
Enumeration date
07/05/2006
Last updated
05/22/2018
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