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Individual

PAM A. MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
577923
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
039610302
TX
05
039610303
TX
05
039610304
TX
05
039610305
TX
05
039610306
TX
05
039610307
TX
05
039610308
TX
05
039610309
TX
05
039610310
TX
Enumeration date
12/28/2006
Last updated
05/27/2009
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