Provider Demographics
NPI:1679910087
Name:MARTINEZ, SONIA (DO)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 PEASE ST
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8307
Mailing Address - Country:US
Mailing Address - Phone:956-389-6565
Mailing Address - Fax:956-389-6567
Practice Address - Street 1:2101 PEASE ST
Practice Address - Street 2:SUITE 1G
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8307
Practice Address - Country:US
Practice Address - Phone:956-389-6565
Practice Address - Fax:956-389-6567
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX364300901Medicaid
TX525621YKRCMedicare PIN