MARTIN NEUROBEHAVIORAL CENTER, PC (NPI# 1356573414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356573414 |
| Entity Type | Organization |
| Organization Name | MARTIN NEUROBEHAVIORAL CENTER, PC |
| Practice Address |
3800 Paluxy Dr Suite 450 Tyler TX 75703-1629 |
| Mailing Address |
Po Box 132381 Tyler TX 75713-2381 |
| Practice Telephone | 9032589938 |
| Mailing Telephone | 9032589938 |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-10-26 |
| Authorized Official Name | STEPHEN KELLY MARTIN (OWNER) |
| Authorized Official Telephone | 9032589938 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 4740 | TX | Behavioral Health & Social Service Providers |
| Street Address |
3800 PALUXY DR SUITE 450 |
| City | TYLER |
| State | TX |
| Zip Code | 75703-1629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144233297 | Stephen Kelly Martin | Clinical Neuropsychologist | 3800 Paluxy Dr, Suite 450, Tyler, TX 75703-1629 | 2006-08-13 |
| 1003283946 | Jill Marie Kirkley | Counselor | 3800 Paluxy Dr, Ste 240, Tyler, TX 75703-1629 | 2015-08-26 |
| 1609267962 | Janus Children Services Inc | Counselor | 3800 Paluxy Dr, Suite 150, Tyler, TX 75703-1629 | 2015-02-09 |
| 1326338807 | Richard William Lawrence | Counselor | 3800 Paluxy Dr, Ste. 440, Tyler, TX 75703-1629 | 2011-04-18 |
| 1265613707 | Jennifer Lynn Blakeney | Counselor | 3800 Paluxy Dr, Suite 450, Tyler, TX 75703-1629 | 2007-11-26 |
| 1831227909 | Charles T Fries Edd PC | Psychologist | 3800 Paluxy Dr, Suite 440, Tyler, TX 75703 | 2007-03-01 |
| 1750417960 | Rebecca Ann Slater | Social Worker | 3800 Paluxy Dr, Suite 137, Tyler, TX 75703-1629 | 2007-02-24 |
| 1811040009 | Karon L Harrison | Counselor | 3800 Paluxy Dr, Suite 440, Tyler, TX 75703 | 2007-01-19 |
| 1003970625 | Charles T Fries | Psychologist | 3800 Paluxy Dr, Suite 440, Tyler, TX 75703 | 2006-12-20 |
| 1528145992 | Diana K Walla | Counselor | 3800 Paluxy Dr, Suite 137, Tyler, TX 75703-1629 | 2006-11-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013450220 | Frederick Gary Mears | Clinical Neuropsychologist | 1810 Shiloh Rd Ste 801, Tyler, TX 75703-2457 | 2016-11-21 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1497805659 | Robert Sperry Jr. | Clinical Neuropsychologist | 605 Chase Dr, Suite 2, Tyler, TX 75701-9431 | 2007-01-11 |
| 1619044856 | Barry Wilson Rath | Clinical Neuropsychologist | 826 S Fleishel Ave, Tyler, TX 75701-2016 | 2006-11-30 |
| 1144233297 | Stephen Kelly Martin | Clinical Neuropsychologist | 3800 Paluxy Dr, Suite 450, Tyler, TX 75703-1629 | 2006-08-13 |
| 1326657792 | Pelin D Strebler | Clinical Neuropsychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-07-30 |
| 1609068071 | Charles Raymond Walker | Clinical Neuropsychologist | 2737 S Broadway Ave, Tyler, TX 75701 | 2007-08-09 |
| 1649200700 | Edwin D Robertson | Clinical Neuropsychologist | 701 Olympic Plaza Cir, Tyler, TX 75701-1950 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598375487 | Tara Austin | Clinical Neuropsychologist | 4900 Bagby Ave Apt 819, Waco, TX 76711-0035 | 2020-08-05 |
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1992330864 | Annelizabeth Robinson Carlew | Clinical Neuropsychologist | 6333 Forest Park Rd 1st Fl Bla.100, Dallas, TX 75390-5461 | 2020-03-11 |
| 1710511753 | Gulf Coast Neuropsychology, Pllc | Clinical Neuropsychologist | 1110 Nasa Pkwy Ste 108c, Houston, TX 77058-3351 | 2020-02-28 |
| 1356988372 | Jennifer Reynolds | Clinical Neuropsychologist | 8005 Canyon Parke Ct, Austin, TX 78726-4029 | 2019-12-09 |
| 1649835216 | Kaleidoscope Counseling and Assessment | Clinical Neuropsychologist | 1705 S Capital of Texas Hwy Ste 130, Austin, TX 78746-6587 | 2019-05-08 |
| 1104392067 | Neuropsychological Services of Texarkana Pllc | Clinical Neuropsychologist | 5411 Plaza Dr Ste E, Texarkana, TX 75503-1667 | 2018-10-18 |
| 1801370184 | Professional Exam Services Inc. | Clinical Neuropsychologist | 2233 E Grauwyler Rd Ste 107, Irving, TX 75061-3239 | 2018-09-21 |
| 1255815072 | Seema Pandya | Clinical Neuropsychologist | 9101 N Central Expy Ste 230, Dallas, TX 75231-6079 | 2018-09-18 |
| 1972097145 | Juliette Galindo | Clinical Neuropsychologist | 1333 Moursund Ave, Psychology/neuropsychology H124, Houston, TX 77030-3405 | 2018-06-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.