Individual
MARTIN V THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 PARK BEND DR STE 201, AUSTIN, TX 78758-5388
(210) 495-7246
(210) 495-7245
Mailing address
PO BOX 117475, CARROLLTON, TX 75011-7475
(210) 495-7246
(210) 495-7245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
M3402
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
M3402
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
M3402
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033888
—
MO
05
—
200421190A
—
KS
05
—
200421190B
—
MO
05
—
201411501
—
MO
05
—
201421902
—
TX
01
—
36986011
BCBS OF KC
MO
01
—
7893841
AETNA
MO
01
—
8CB638
BCBS
TX
01
—
P00329857
RAILROAD
TX
01
—
P00924214
RR MEDICARE
TX
Enumeration date
06/24/2006
Last updated
12/18/2018
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