Individual
REGINA CAROL MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 GARDINA APT 116, SAN ANTONIO, TX 78201-3363
(210) 463-7398
Mailing address
1400 GARDINA APT 116, SAN ANTONIO, TX 78201-3363
(210) 463-7398
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0771219
DRIVERLICENSE
TX
Enumeration date
12/31/2018
Last updated
12/31/2018
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