Provider Demographics
NPI:1689941544
Name:MARTINEZ, MARIE MAE ESPERA (MD)
Entity Type:Individual
Prefix:
First Name:MARIE MAE
Middle Name:ESPERA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2961 MOSSROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5119
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:1248 AUSTIN HWY STE 214
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-4867
Practice Address - Country:US
Practice Address - Phone:210-828-2531
Practice Address - Fax:210-828-2532
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP2034207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB158712OtherWELLMED MEDICARE
TX3078248-01OtherWELLMED MEDICAID