Individual
MR. GERARDO MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRT,RPSGT
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
6102
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1566069-01
—
TX
01
—
PL7138
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/10/2007
Last updated
02/23/2010
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