Provider Demographics
NPI:1124368527
Name:MARTZ MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:MARTZ MEDICAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-406-2896
Mailing Address - Street 1:PO BOX 815844
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75381-5844
Mailing Address - Country:US
Mailing Address - Phone:972-406-2896
Mailing Address - Fax:972-406-2767
Practice Address - Street 1:8 MEDICAL PKWY
Practice Address - Street 2:SUITE 106
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7859
Practice Address - Country:US
Practice Address - Phone:972-406-2896
Practice Address - Fax:972-406-2767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty