Provider Demographics
NPI:1164426649
Name:MARTINEZ, JOSE ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALEJANDRO
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:ALEX
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4201 BEE CAVE RD
Mailing Address - Street 2:SUITE B 200
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6465
Mailing Address - Country:US
Mailing Address - Phone:512-478-9845
Mailing Address - Fax:512-478-3067
Practice Address - Street 1:4201 BEE CAVE RD
Practice Address - Street 2:SUITE B 200
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6465
Practice Address - Country:US
Practice Address - Phone:512-478-9845
Practice Address - Fax:512-478-3067
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1546207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1992984280OtherMEDICARE IDENTIFICATION NUMBER
TX3383651OtherBLUELINK
TX1992984280OtherMEDICARE IDENTIFICATION NUMBER
TXF83651Medicare UPIN