Provider Demographics
NPI:1891984076
Name:MARTINEZ, GABRIEL (OD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 N. ZARAGOSA RD
Mailing Address - Street 2:SUITE 208-B
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936
Mailing Address - Country:US
Mailing Address - Phone:915-857-3937
Mailing Address - Fax:
Practice Address - Street 1:1821 N ZARAGOSA
Practice Address - Street 2:SUITE 208-B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7912
Practice Address - Country:US
Practice Address - Phone:915-857-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7167T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist