Individual
MS. MARY GLORIA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8933 ANKERSON ST, EL PASO, TX 79904-1320
(915) 629-2079
(915) 755-7191
Mailing address
PO BOX 640726, EL PASO, TX 79904-0726
(915) 474-3537
(915) 755-7191
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
012684
TX
253Z00000X
In Home Supportive Care Agency
Primary
012684
TX
3747P1801X
Personal Care Attendant
012684
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669646402
—
TX
Enumeration date
02/08/2019
Last updated
02/08/2019
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