Provider Demographics
NPI:1255349585
Name:MARTINEZ, STEVE DAN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:DAN
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15407 CONIFER BAY CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3185
Mailing Address - Country:US
Mailing Address - Phone:281-286-3963
Mailing Address - Fax:
Practice Address - Street 1:1201 LAKE ROBBINS DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1181
Practice Address - Country:US
Practice Address - Phone:832-636-3963
Practice Address - Fax:832-636-9400
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4346207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC18091Medicare UPIN