Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 10599 | TX |
NPI | 1073877056 |
---|---|
Provider Name | Dr. Daniel A Martinez |
First Address | Mesquite, TX 75149-1332 |
Second Address | Dallas, TX 75220-1216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 25/06/2012 |