Provider Demographics
NPI:1346221884
Name:MARTINEZ, JOAQUIN G (MD)
Entity Type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:G
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 1:15844 YORKTOWN CROSSING PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5280
Mailing Address - Country:US
Mailing Address - Phone:281-859-4060
Mailing Address - Fax:281-859-4055
Practice Address - Street 1:15844 YORKTOWN CROSSING PKWY STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5280
Practice Address - Country:US
Practice Address - Phone:281-859-4060
Practice Address - Fax:281-859-4055
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2532207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10020041Medicaid
TXENJ18Medicare PIN
TXG56408Medicare UPIN