Provider Demographics
NPI:1659777357
Name:RITA MARTINEZ, CRNFA, LLC
Entity Type:Organization
Organization Name:RITA MARTINEZ, CRNFA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:214-298-8743
Mailing Address - Street 1:7324 GASTON AVE
Mailing Address - Street 2:SUITE 124-471
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-6126
Mailing Address - Country:US
Mailing Address - Phone:214-298-8743
Mailing Address - Fax:214-553-2660
Practice Address - Street 1:7324 GASTON AVE
Practice Address - Street 2:SUITE 124-471
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-6126
Practice Address - Country:US
Practice Address - Phone:214-298-8743
Practice Address - Fax:214-553-2660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654376282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital