Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | E5842 | TX |
NPI | 1003941790 |
---|---|
Provider Name | Hector Martinez Viera |
First Address | Houston, TX 77030-1904 |
Second Address | Houston, TX 77030-1904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AK61 | BLUE CROSS BLUE SHIELD (01) | TX |
C78089 | (02) | TX |