Individual
GUSTAVO R MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
814 MYRTLE AVE, EL PASO, TX 79901-1512
(915) 241-7272
(877) 587-9452
Mailing address
814 MYRTLE AVE, EL PASO, TX 79901-1512
(915) 241-7272
(877) 587-9452
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01545
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071353903
—
TX
01
—
88048Q
BCBS
TX
Enumeration date
02/24/2006
Last updated
11/14/2009
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