Provider Demographics
NPI:1730262080
Name:MARTIN, SUSAN CATHERINE (PT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:CATHERINE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 BRENHAM DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-9003
Mailing Address - Country:US
Mailing Address - Phone:972-562-0713
Mailing Address - Fax:972-562-0932
Practice Address - Street 1:5100 ELDORADO PKWY
Practice Address - Street 2:STE 110
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6309
Practice Address - Country:US
Practice Address - Phone:972-562-0713
Practice Address - Fax:972-562-0932
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist