Provider Demographics
NPI:1760198964
Name:MARTINEZ GONZALEZ, YAIMA (NP)
Entity Type:Individual
Prefix:
First Name:YAIMA
Middle Name:
Last Name:MARTINEZ GONZALEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 BANKS LANDING CT
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-4553
Mailing Address - Country:US
Mailing Address - Phone:281-661-1079
Mailing Address - Fax:
Practice Address - Street 1:3935 BANKS LANDING CT
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-4553
Practice Address - Country:US
Practice Address - Phone:281-661-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1109289363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner