Provider Demographics
NPI:1356870364
Name:MARTINEZ, CARLOS ALFREDO JR
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:ALFREDO
Last Name:MARTINEZ
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 N JACKSON RD STE 22
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-3694
Mailing Address - Country:US
Mailing Address - Phone:956-884-6137
Mailing Address - Fax:
Practice Address - Street 1:108 N JACKSON RD STE 22
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-3694
Practice Address - Country:US
Practice Address - Phone:956-884-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health