Individual
JIMMY A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3408 OLSEN BLVD, AMARILLO, TX 79109
(806) 355-5633
(806) 355-9133
Mailing address
3408 OLSEN BLVD, AMARILLO, TX 79109-3017
(806) 355-5633
(806) 355-9133
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
04122TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040680301
—
TX
01
—
83134Q
BCBS
TX
Enumeration date
03/10/2006
Last updated
09/23/2014
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