Provider Demographics
NPI:1770821514
Name:MARTINEZ, EVA BELINDA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:BELINDA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 CLIFF MANOR ST
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-3865
Mailing Address - Country:US
Mailing Address - Phone:817-680-4443
Mailing Address - Fax:
Practice Address - Street 1:1448 CLIFF MANOR ST
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-3865
Practice Address - Country:US
Practice Address - Phone:817-680-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist