Provider Demographics
NPI:1114268919
Name:MARTINEZ, CELINA (PHARM D)
Entity Type:Individual
Prefix:MISS
First Name:CELINA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BRAHEA DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6783
Mailing Address - Country:US
Mailing Address - Phone:956-645-8778
Mailing Address - Fax:
Practice Address - Street 1:4801 SAN DARIO AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5749
Practice Address - Country:US
Practice Address - Phone:956-725-0171
Practice Address - Fax:956-728-7441
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist