Martin Tyler Martinez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2077941 Issued in TX

Practice address

208 N Prairie St
Pilot Point, TX 76258-4057

Phone

(940) 324-6620

Fax

(940) 324-6624

NPI assigned

Aug 27, 2018

Last updated

Aug 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mythical Fitness Trainers LLC

  dba Fortitude Health and Performance

  • Physical Therapy Clinic/Center
  • Sanger, TX
  • NPI 1912591959
  Authorized official Same address or phone

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1962983056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 LAKEPARK DR",
            "city": "SANGER",
            "state": "TX",
            "postal_code": "762661406",
            "telephone_number": "806-215-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N PRAIRIE ST",
            "city": "PILOT POINT",
            "state": "TX",
            "postal_code": "762584057",
            "telephone_number": "940-324-6620",
            "fax_number": "940-324-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARTIN",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2077941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Jones
• Gunjan Kant, M.D.
• Chang Hyun Lee, DMD
• Ashley Lowe, DNP, APRN, PMHNP
• Lindsay Nicole Lyons, APRN, AGACNP-BC
• Rex D. Mask, R. PH.
• Justin Clay McConnell, CPHT
• More MD Houston LLC (MoreMD)
• More MD Tyler LLC (MoreMD)
• Caroline Mwembu Muiga

• Physical Therapy Assistant in Pilot Point, TX
• Providers in Pilot Point, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.