Individual
DR. JACK MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5934 S STAPLES ST, SUITE 210, CORPUS CHRISTI, TX 78413-3842
(361) 992-1212
Mailing address
7633 LOVAIN DR, CORPUS CHRISTI, TX 78414-6159
(361) 992-1212
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2311
TX
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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