Provider Demographics
NPI:1871913822
Name:RALPH W MARTIN ED. D. PC
Entity type:Organization
Organization Name:RALPH W MARTIN ED. D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-801-8280
Mailing Address - Street 1:12700 HILLCREST RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2033
Mailing Address - Country:US
Mailing Address - Phone:214-691-2136
Mailing Address - Fax:214-691-5380
Practice Address - Street 1:12700 HILLCREST RD
Practice Address - Street 2:SUITE 212
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2033
Practice Address - Country:US
Practice Address - Phone:214-691-2136
Practice Address - Fax:214-691-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty