Provider Demographics
NPI:1831940774
Name:MARTINEZ AGUILAR, YIRKA
Entity type:Individual
Prefix:
First Name:YIRKA
Middle Name:
Last Name:MARTINEZ AGUILAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13422 BLACKBIRD DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3727
Mailing Address - Country:US
Mailing Address - Phone:786-991-7660
Mailing Address - Fax:
Practice Address - Street 1:13422 BLACKBIRD DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3727
Practice Address - Country:US
Practice Address - Phone:786-991-7660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1043682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily