Provider Demographics
NPI:1922328806
Name:MARTINEZ-WILSON, ADRIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:
Last Name:MARTINEZ-WILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5958
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5958
Mailing Address - Country:US
Mailing Address - Phone:956-362-8677
Mailing Address - Fax:956-362-7253
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5503
Practice Address - Country:US
Practice Address - Phone:956-362-8677
Practice Address - Fax:956-362-7253
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6219207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX322961905Medicaid
TX299818YZ84Medicare PIN