Provider Demographics
NPI:1740810670
Name:MARTINEZ, STEVEN (PA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:810 N ZANG BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4263
Mailing Address - Country:US
Mailing Address - Phone:214-941-4243
Mailing Address - Fax:214-941-1153
Practice Address - Street 1:2975 E BROAD ST STE 200
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9186
Practice Address - Country:US
Practice Address - Phone:817-453-3500
Practice Address - Fax:817-453-3520
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2020-04-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1740810670OtherNPI