Basic Information
| Provider Information | |||||||||
| NPI: | 1164924015 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARTINEZ-PATEL | ||||||||
| FirstName: | SOLEDAD | ||||||||
| MiddleName: | CAROLINA | ||||||||
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| Credential: | MOT, OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 NE LOOP 820; BUSINESS TOWER 1, | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | HURST | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172928787 | ||||||||
| FaxNumber: | 8177896849 | ||||||||
| Practice Location | |||||||||
| Address1: | 17480 DALLAS PKWY STE 221 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752877361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4692918500 | ||||||||
| FaxNumber: | 8663414918 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2018 | ||||||||
| LastUpdateDate: | 03/07/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | 114770 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.