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Individual

DR. DIETER ROBERT MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
901 W BEN WHITE BLVD, AUSTIN, TX 78704-6903
(512) 447-2211
Mailing address
7000 N MO PAC EXPY STE 420, AUSTIN, TX 78731-3055
(512) 482-0045
(512) 476-9892

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L6106
TX
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
L6106
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1608795-01
TX
05
160879602
TX
Enumeration date
06/29/2006
Last updated
03/08/2018
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