Provider Demographics
NPI:1801271069
Name:MARTINEZ PRO, SYLVIA ALEJANDRA (MD)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:ALEJANDRA
Last Name:MARTINEZ PRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8515 GREENVILLE AVE STE N108
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7035
Mailing Address - Country:US
Mailing Address - Phone:214-221-0855
Mailing Address - Fax:214-710-1303
Practice Address - Street 1:5750 PINELAND DR # 260
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5300
Practice Address - Country:US
Practice Address - Phone:214-379-4393
Practice Address - Fax:214-221-1437
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR6044208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program