Sandra Ivelisse Martin

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

120027 Issued in TX

Practice address

4100 N Sam Houston Pkwy W Ste 240
Houston, TX 77086-1466

Phone

(832) 968-7155

Fax

(713) 383-9795

NPI assigned

Jul 26, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TCG Home Health LLC

  dba Aveanna Healthcare

  • Rehabilitation Clinic/Center
  • Houston, TX
  • NPI 1902228604
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1326774084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 N SAM HOUSTON PKWY W STE 240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770861466",
            "telephone_number": "832-968-7155",
            "fax_number": "713-383-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 N SAM HOUSTON PKWY W STE 240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770861466",
            "telephone_number": "832-968-7155",
            "fax_number": "713-383-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SANDRA",
        "middle_name": "IVELISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "120027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Martin
• Robert Lamar Martin, GNP-BC
• Rochelle Martin
• Ruben Dario Martin Jr.
• Samantha Elizabeth Martin, CNM
• Sarah L Martin, LPC
• Sean Martin, LPC
• Sean K Martin, M.D.
• Shannon Nicole Martin, LPC
• Shantimol Martin

• Speech-Language Pathologist in Houston, TX
• Providers in Houston, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.