Provider Demographics
NPI:1417390980
Name:MARTINEZ, HIRAM ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:HIRAM
Middle Name:ALBERTO
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2660 GULF FREEWAY SOUTH #2
Mailing Address - Street 2:UTMB HEALTH PRIMARY CARE MULTISPECIALTY CENTER
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573
Mailing Address - Country:US
Mailing Address - Phone:832-505-2060
Mailing Address - Fax:
Practice Address - Street 1:2660 GULF FREEWAY
Practice Address - Street 2:UTMB HEALTH PRIMARY CARE
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:832-505-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10047108207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBP10047108OtherSTATE OF TEXAS PHYSICIAN IN TRAINING PERMIT