Provider Demographics
NPI:1922569268
Name:MARTINEZ, ANDREW HALL (BS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:HALL
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CIVIC CTR STE 103
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-3829
Mailing Address - Country:US
Mailing Address - Phone:918-574-2937
Mailing Address - Fax:
Practice Address - Street 1:600 CIVIC CTR STE 103
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-3829
Practice Address - Country:US
Practice Address - Phone:918-574-2937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator