Individual
DAVID MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 E FERGUSON ST STE 608, TYLER, TX 75702-5756
(903) 705-0070
Mailing address
9992 COUNTY ROAD 3111 N, KILGORE, TX 75662-7528
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
311926
TX
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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