Individual
MARIO ANTHONY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7030 NEW SANGER AVE STE 202, WACO, TX 76712-4074
(254) 772-4400
Mailing address
7030 NEW SANGER AVE STE 202, WACO, TX 76712-4074
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
T5621
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10061512
PIT
TX
Enumeration date
06/02/2017
Last updated
02/10/2023
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