Organization
HENRY E. MARTINEZ MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY ENOC MARTINEZ MD (OWNER)
(979) 297-3098
Entity
Organization
Contact information
Practice address
201 OAK DR S, SUITE 202, LAKE JACKSON, TX 77566-5676
(979) 297-3098
Mailing address
201 OAK DR S, SUITE 202, LAKE JACKSON, TX 77566-5676
(979) 297-3098
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
GP ID FOR TRICARE
TX
01
—
0061KZ
GROUP ID FOR BCBS
TX
05
—
165446901
—
TX
01
—
DC2985
GP ID# RAILROAD MEDICARE
TX
Enumeration date
04/12/2007
Last updated
10/20/2008
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