Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 66021-20 | WI |
Y | 204F00000X | Transplant Surgeon | R8050 | TX |
NPI | 1093070294 |
---|---|
Provider Name | Dr. Eric Javier Martinez |
First Address | Dallas, TX 75246-2064 |
Second Address | Dallas, TX 75246-2064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2012 |
Last Update Date | 02/05/2019 |