Individual
EDWARD A MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1212 N HIGHWAY 377, SUITE 119, ROANOKE, TX 76262-6916
(682) 831-1591
(682) 831-1598
Mailing address
1212 N HIGHWAY 377, SUITE 119, ROANOKE, TX 76262-6916
(682) 831-1591
(682) 831-1598
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04174
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA04174
STATE LICENSE NUMBER
TX
Enumeration date
12/01/2008
Last updated
06/10/2013
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