Basic Information
| Provider Information | |||||||||
| NPI: | 1538486451 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARTINEZ | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | LUIS | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1140 BUSINESS CENTER DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770432744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139325757 | ||||||||
| FaxNumber: | 7139325750 | ||||||||
| Practice Location | |||||||||
| Address1: | 18951 N MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | HUMBLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773384217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815407700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2010 | ||||||||
| LastUpdateDate: | 11/07/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | P5418 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.