Provider Demographics
NPI:1285641704
Name:MARTINEZ, RAUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:A
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 1:1120 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5662
Mailing Address - Country:US
Mailing Address - Phone:956-383-1721
Mailing Address - Fax:956-383-2205
Practice Address - Street 1:1120 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5662
Practice Address - Country:US
Practice Address - Phone:956-383-1721
Practice Address - Fax:956-383-2205
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2281207RC0000X
MA35789207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1331795-08Medicaid
TX1331795-08Medicaid
TX614426Medicare PIN