Provider Demographics
NPI:1518919141
Name:REPINECZ, MARTIN GREGORY (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:GREGORY
Last Name:REPINECZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12529 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-4509
Mailing Address - Country:US
Mailing Address - Phone:281-484-0988
Mailing Address - Fax:281-484-0989
Practice Address - Street 1:12529 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-4509
Practice Address - Country:US
Practice Address - Phone:281-484-0988
Practice Address - Fax:281-484-0989
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX569213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092757601Medicaid
TX092757601Medicaid
TX5098420001Medicare NSC