Martin Neurobehavioral Center, PC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

4740 Issued in TX

Legal business name

MARTIN NEUROBEHAVIORAL CENTER, PC

Practice address

3800 Paluxy Dr
Suite 450
Tyler, TX 75703-1629

Phone

(903) 258-9938

NPI assigned

Aug 21, 2009

Organization subpart

No

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

Authorized official

Name

Stephen Kelly Martin, PH.D.NPI 1144233297

Title

Owner

Phone

(903) 258-9938

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Kelly Martin, PH.D.

  • Clinical Neuropsychologist
  • Tyler, TX
  • NPI 1144233297
  Medicare reassignment NPD Authorized official
• Jennifer Lynn Blakeney, M.S.

  • Professional Counselor
  • Tyler, TX
  • NPI 1265613707
  NPD (past)
• Stephen C Westmoreland, ED. D.

  • Psychologist
  • Tyler, TX
  • NPI 1023103603
  NPD (past)

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1356573414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132381",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757132381",
            "telephone_number": "903-258-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PALUXY DR",
            "address_2": "SUITE 450",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031629",
            "telephone_number": "903-258-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN NEUROBEHAVIORAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-21",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-258-9938",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "4740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph M Martellotto, D.O.
• Martial Arts Therapy
• Martin Blanchard Jr., D.C., PLLC
• Sharon J. Martin Holm, M.D.
• Martin Medical PLLC
• Martin Pharmacy Investments PLLC
• Amanda J Martin
• Amanda N Martin
• Angela H Martin, M.S., CCC-SLP
• Barbara Jean Martin, R.PH

• Clinical Neuropsychologist in Tyler, TX
• Providers in Tyler, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.