Individual
MRS. ELIZABETH SUE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1512 S 30TH CT, BROKEN ARROW, OK 74014-7401
(918) 277-5112
Mailing address
4502 E 41ST ST, TULSA, OK 74135-2536
(918) 660-3842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5251
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/13/2021
Last updated
05/13/2025
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