Provider Demographics
NPI:1689344111
Name:AZALIA MARTINEZ II, M.D.
Entity Type:Organization
Organization Name:AZALIA MARTINEZ II, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AZALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:915-637-5541
Mailing Address - Street 1:24165 IH 10 W STE 217
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1160
Mailing Address - Country:US
Mailing Address - Phone:210-660-8883
Mailing Address - Fax:
Practice Address - Street 1:LAUREL RIDGE TREATMENT CENTER
Practice Address - Street 2:17720 CORPORATE WOODS DRIVE
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259
Practice Address - Country:US
Practice Address - Phone:210-491-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty