Alex Martynenko, | |
1109 Church St, Colleyville, TX 76034-5849 | |
(817) 498-3919 | |
(817) 498-7080 |
Full Name | Alex Martynenko |
---|---|
Gender | Male |
Speciality | Physical Medicine & Rehabilitation |
Location | 1109 Church St, Colleyville, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124833629 | NPI | - | NPPES |
1404068 | Other | TX | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208100000X | Physical Medicine & Rehabilitation | 1404068 (Texas) | Primary |
Entity Name | Colleyville Physical Therapy And Sports Rehab, Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134158371 PECOS PAC ID: 1153315791 Enrollment ID: O20040414001234 |
Mailing Address | Practice Location Address |
---|---|
Alex Martynenko, 1109 Church St, Colleyville, TX 76034-5849 Ph: (817) 498-3919 | Alex Martynenko, 1109 Church St, Colleyville, TX 76034-5849 Ph: (817) 498-3919 |
Dr. Sankar Pemmaraju, D.O. Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 6904 Peters Path, Colleyville, TX 76034 Phone: 817-488-9874 Fax: 817-488-2865 | |
Erica Wong, Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 1109 Church St, Colleyville, TX 76034 Phone: 817-498-3919 Fax: 817-498-7080 |