Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | ME90300 | FL |
NPI | 1275514135 |
---|---|
Provider Name | Dr. Tanya M Martinez-Fernandez |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75235-7701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 28/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270043300 | (05) | FL |
I15201 | (02) | FL |