Provider Demographics
NPI:1295731164
Name:MARTINEZ, JEFFREY M (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 BARLITE BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1362
Mailing Address - Country:US
Mailing Address - Phone:210-540-6766
Mailing Address - Fax:210-903-8044
Practice Address - Street 1:7500 BARLITE BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1362
Practice Address - Country:US
Practice Address - Phone:210-540-6766
Practice Address - Fax:210-903-8044
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH64102086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142115813Medicaid
TXS64174OtherMEDICARE UPIN
TX142115801Medicaid
TX8C0434OtherMEDICARE W/PVA
TX8C0434OtherMEDICARE W/PVA
TX142115801Medicaid