Provider Demographics
NPI:1942524251
Name:MARTINEZ, JAVIER (LSA)
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7250 LIBERTY MESA LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-3996
Mailing Address - Country:US
Mailing Address - Phone:281-691-0844
Mailing Address - Fax:
Practice Address - Street 1:7250 LIBERTY MESA LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-3996
Practice Address - Country:US
Practice Address - Phone:281-691-0844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00413363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical