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Individual

DAVID C MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,P.A.

Contact information

Practice address
619 S FLEISHEL AVE STE 201, TYLER, TX 75701-2004
(903) 606-5777
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
052410
GA
207Q00000X
Family Medicine Physician
Primary
K9119
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
031355302
TX
05
031355303
TX
05
460041120A
GA
01
75-2616977-007
TRICARE
TX
01
75-2616977-108
TRICARE
TX
01
752616977118
TRICARE
TX
01
8DB081
BCBS
TX
01
8DC095
BCBS
TX
Enumeration date
08/22/2006
Last updated
02/17/2026
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