Provider Demographics
NPI:1710461108
Name:MARTINEZ, JANE PINELL
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:PINELL
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PLUM FALLS LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-3605
Mailing Address - Country:US
Mailing Address - Phone:281-799-7709
Mailing Address - Fax:
Practice Address - Street 1:9598 ROWLETT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-2414
Practice Address - Country:US
Practice Address - Phone:832-386-0160
Practice Address - Fax:832-386-0165
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist