Provider Demographics
NPI:1205839776
Name:MARTINEZ, MARTHA (MD, FACOG)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 E PRICE RD
Mailing Address - Street 2:BLDG A
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-3531
Mailing Address - Country:US
Mailing Address - Phone:956-544-2001
Mailing Address - Fax:956-546-4567
Practice Address - Street 1:1076 E LOS EBANOS BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-9988
Practice Address - Country:US
Practice Address - Phone:956-544-2001
Practice Address - Fax:956-546-4567
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8909207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1325714-02Medicaid
TX88N805OtherBLUE CROSS
TX82G727Medicare PIN
TX88N805OtherBLUE CROSS