Individual
MARTIN PABLO FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-4391
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
M7968
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188519601
—
TX
01
—
188519602
CIDC
TX
01
—
8G9096
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/14/2007
Last updated
04/17/2024
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