Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 10209 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 10209 | TX |
Y | 363L00000X | Nurse Practitioner | 884552 | TX |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 884552 | TX |
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP134332 | TX |
NPI | 1346375383 |
---|---|
Provider Name | Mr. Alejandro Tomas Martinez |
First Address | Mcallen, TX 78504-6000 |
Second Address | Mcallen, TX 78504-2781 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 12/10/2021 |