Organization
DAGOBERTO MARTINEZ, MDPA
Active
Other names
Clinica Santa Maria
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARYANN FORE WHCNP (CHEIF OPERATING OFFICER)
(956) 544-2001
Entity
Organization
Contact information
Practice address
95 E PRICE RD BLDG A, BROWNSVILLE, TX 78521-3531
(956) 544-2001
(956) 546-4567
Mailing address
95 E PRICE RD BLDG A, BROWNSVILLE, TX 78521-3531
(956) 544-2001
(956) 546-4567
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081598701
—
TX
01
—
9002000000A99J0
BLUE CROSS AND BLUE SHIEL
TX
Enumeration date
05/25/2006
Last updated
02/10/2021
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