CR Martin M D P a

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

H5255 Issued in TX

Legal business name

CR MARTIN M D P A

Practice address

703 E Marshall Ave
Suite 3008
Longview, TX 75601-5500

Phone

(903) 315-2740

Fax

(903) 315-2742

NPI assigned

Oct 13, 2010

Organization subpart

No

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

Authorized official

Name

Charles R. Martin, M.D.

Title

President

Phone

(903) 315-2740

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1699085563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 E MARSHALL AVE",
            "address_2": "STE 3008",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015500",
            "telephone_number": "903-315-2740",
            "fax_number": "903-315-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 E MARSHALL AVE",
            "address_2": "SUITE 3008",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015500",
            "telephone_number": "903-315-2740",
            "fax_number": "903-315-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CR MARTIN M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-315-2740",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "H5255",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "H5255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116457601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "E0101110",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Longview, TX
• Providers in Longview, TX by specialty
• Pulmonary Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.