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Individual

MR. DENNIS W MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240-6533
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
(972) 715-9976

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
606699
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP108248
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
84955U
BCBS
TX
Enumeration date
02/01/2006
Last updated
03/20/2017
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