Provider Demographics
NPI:1578931382
Name:MARTINEZ, GREGORY (APRN)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 BARLITE BLVD STE 313
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1363
Mailing Address - Country:US
Mailing Address - Phone:210-924-5097
Mailing Address - Fax:210-924-1116
Practice Address - Street 1:7500 BARLITE BLVD STE 313
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1363
Practice Address - Country:US
Practice Address - Phone:210-924-5097
Practice Address - Fax:210-924-1116
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128916164W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse