Provider Demographics
NPI:1508524216
Name:MARTINEZ, ALEJANDRA (NP-C)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7031 BLUE SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3047
Mailing Address - Country:US
Mailing Address - Phone:956-708-1775
Mailing Address - Fax:
Practice Address - Street 1:7031 BLUE SPRUCE ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3047
Practice Address - Country:US
Practice Address - Phone:956-708-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty