Provider Demographics
NPI:1144225715
Name:MARTINEZ, RUBEN DAVILA (MD)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:DAVILA
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 1:1821 S SESAME SQ STE 5
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7941
Mailing Address - Country:US
Mailing Address - Phone:956-423-9977
Mailing Address - Fax:956-428-2777
Practice Address - Street 1:1821 S SESAME SQ STE 5
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7941
Practice Address - Country:US
Practice Address - Phone:956-423-9977
Practice Address - Fax:956-428-2777
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1783207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129763100OtherVHP
TX137624611Medicaid
TX8F3420OtherBCBSTX
TX8C7152Medicare PIN
TX129763100OtherVHP
TXF40825Medicare UPIN