Provider Demographics
NPI:1568857738
Name:MARTE A MARTINEZ MD PLLC
Entity Type:Organization
Organization Name:MARTE A MARTINEZ MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTE
Authorized Official - Middle Name:AQULIES
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-795-8393
Mailing Address - Street 1:PO BOX 450708
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-0017
Mailing Address - Country:US
Mailing Address - Phone:956-795-8393
Mailing Address - Fax:956-795-8396
Practice Address - Street 1:7614 ROCIO DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6550
Practice Address - Country:US
Practice Address - Phone:956-795-8393
Practice Address - Fax:956-795-8396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8036174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01080539OtherMEDICARE RR PIN
TX287561903Medicaid
TXP01080539OtherMEDICARE RR PIN