Provider Demographics
NPI:1801232863
Name:MARTIN, MELISSA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7110 ROCIO DR STE 10
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6674
Mailing Address - Country:US
Mailing Address - Phone:956-396-0028
Mailing Address - Fax:956-394-1145
Practice Address - Street 1:7110 ROCIO DR STE 10
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6674
Practice Address - Country:US
Practice Address - Phone:956-396-0028
Practice Address - Fax:956-394-1145
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ8914207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine