Organization
CR MARTIN M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES R. MARTIN M.D. (PRESIDENT)
(903) 315-2740
Entity
Organization
Contact information
Practice address
703 E MARSHALL AVE, SUITE 3008, LONGVIEW, TX 75601-5500
(903) 315-2740
(903) 315-2742
Mailing address
703 E MARSHALL AVE, STE 3008, LONGVIEW, TX 75601-5500
(903) 315-2740
(903) 315-2742
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
H5255
TX
207RP1001X
Pulmonary Disease Physician
Primary
H5255
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116457601
—
TX
01
—
E0101110
DPS
TX
Enumeration date
10/13/2010
Last updated
03/07/2023
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