Provider Demographics
NPI:1851028880
Name:MARTINEZ, CRYSTAL M (CPNP)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:CPNP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12377 MERIT DR STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-3126
Mailing Address - Country:US
Mailing Address - Phone:972-957-3000
Mailing Address - Fax:
Practice Address - Street 1:1512 N ZARAGOZA RD STE A1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8903
Practice Address - Country:US
Practice Address - Phone:915-855-7700
Practice Address - Fax:915-855-8301
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1085602363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics