Provider Demographics
NPI:1497716344
Name:MARTINEZ, AZALIA V (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:AZALIA
Middle Name:V
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E RIO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4815
Mailing Address - Country:US
Mailing Address - Phone:915-545-1261
Mailing Address - Fax:915-545-2450
Practice Address - Street 1:1300 E RIO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4815
Practice Address - Country:US
Practice Address - Phone:915-545-1261
Practice Address - Fax:915-545-2450
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1781207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMU4800Medicaid
TX8U7818OtherBCBS
TXP00364147OtherRAILROAD
TX138181616Medicaid
TX8U7818OtherBCBS
TXC18881Medicare UPIN