Provider Demographics
NPI:1114923331
Name:MARTINEZ, ALBERTO NOE (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:NOE
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION
Mailing Address - State:TX
Mailing Address - Zip Code:76849-4632
Mailing Address - Country:US
Mailing Address - Phone:325-446-3999
Mailing Address - Fax:
Practice Address - Street 1:1003 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:JUNCTION
Practice Address - State:TX
Practice Address - Zip Code:76849-4632
Practice Address - Country:US
Practice Address - Phone:325-446-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2021-04-06
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
TXG5337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC18893Medicare UPIN
TXPOOOGF649Medicare ID - Type Unspecified