Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
JHONNY MARTIN BAZAN MD PA
Active
Organization
JHONNY MARTIN BAZAN MD PA
Active
Other names
San Martin de Porres Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JHONNY MARTIN BAZAN MD (OWNER MD/ PROVIDER/ PRESIDENT)
(956) 519-9500
Entity
Organization
Contact information
Practice address
1337 E PALMA VISTA DR STE A, PALMVIEW, TX 78572-2055
(956) 519-9500
(956) 519-4549
Mailing address
1337 E PALMA VISTA DR STE A, PALMVIEW, TX 78572-2055
(956) 519-9500
(956) 514-9414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
K1355
TX
208D00000X
General Practice Physician
K1355
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0066NL
BLUE CROSS BLUE SHIELD
TX
05
—
041729703
—
TX
05
—
041729705
—
TX
05
—
173560701
—
TX
01
—
1912169459
NPI
TX
01
—
220041063
CASE MANAGEMENT
TX
Enumeration date
12/13/2006
Last updated
10/19/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up