Individual
MRS. ELVIA MARTINEZ BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12505 LEBANON RD, FRISCO, TX 75035-8298
(972) 963-3333
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
Q4197
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349081501
—
TX
05
—
349081502
—
TX
01
—
8FF420
BLUE CROSS BLUE SHIELD
TX
01
—
8FG397
BLUE CROSS BLUE SHIELD
TX
01
—
P01498206
RAILROAD MEDICARE
—
01
—
P01498207
RAILROAD MEDICARE
—
Enumeration date
09/21/2010
Last updated
05/23/2022
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