Provider Demographics
NPI:1043712995
Name:MARTINEZ, BIANCA DENISE (RN)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:DENISE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 VILLA SECA
Mailing Address - Street 2:
Mailing Address - City:HORIZON
Mailing Address - State:TX
Mailing Address - Zip Code:79928
Mailing Address - Country:US
Mailing Address - Phone:915-630-0962
Mailing Address - Fax:
Practice Address - Street 1:713 VILLA SECA
Practice Address - Street 2:
Practice Address - City:HORIZON
Practice Address - State:TX
Practice Address - Zip Code:79928
Practice Address - Country:US
Practice Address - Phone:915-630-0962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX915804163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse