Organization
WAY OUT WEST SPINE AND MOBILITY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MARTINEZ II DO (LEAD PHYSICIAN)
(682) 285-1044
Entity
Organization
Contact information
Practice address
120 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104-1256
(682) 285-1044
(855) 361-0894
Mailing address
120 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104-1256
(682) 285-1044
(855) 361-0894
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
03/14/2019
Last updated
07/26/2022
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