Provider Demographics
NPI:1275597593
Name:MARTINEZ, ROBERTO DAVID (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:DAVID
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:PO BOX 5958
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5958
Mailing Address - Country:US
Mailing Address - Phone:956-362-8677
Mailing Address - Fax:
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5503
Practice Address - Country:US
Practice Address - Phone:956-362-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5038207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX365795YZ84Medicare PIN
TX365795YZ84Medicare PIN
TX158433601Medicaid
TX8A0750Medicare PIN
TXP00026320OtherMEDICARE RAILROAD
TX8AW499OtherBCBS
TX158433603Medicaid