Provider Demographics
NPI:1881564268
Name:MARTINEZ, ALEXIS AZENETTE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:AZENETTE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1192 LAZAR DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5602
Mailing Address - Country:US
Mailing Address - Phone:830-776-6655
Mailing Address - Fax:
Practice Address - Street 1:3147 MEGAN ST STE 4
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-6134
Practice Address - Country:US
Practice Address - Phone:830-758-0210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121773235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty