Provider Demographics
NPI:1174843726
Name:MARTINEZ, NICHOLAS PEREZ (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:PEREZ
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8550 DATAPOINT DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3270
Mailing Address - Country:US
Mailing Address - Phone:210-615-8308
Mailing Address - Fax:210-616-2121
Practice Address - Street 1:8550 DATAPOINT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3270
Practice Address - Country:US
Practice Address - Phone:210-615-8308
Practice Address - Fax:210-616-2121
Is Sole Proprietor?:No
Enumeration Date:2010-06-06
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP7155207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program