Provider Demographics
NPI:1902394505
Name:MARTINEZ, TANIA SARAHI (LVN)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:SARAHI
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-1631
Mailing Address - Country:US
Mailing Address - Phone:972-672-9234
Mailing Address - Fax:
Practice Address - Street 1:412 MAPLE DR
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-1631
Practice Address - Country:US
Practice Address - Phone:972-672-9234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-29
Last Update Date:2018-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336182164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse