Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | N0251 | TX |
NPI | 1215138656 |
---|---|
Provider Name | Oscar J. Martinez |
First Address | Austin, TX 78703-4705 |
Second Address | Dallas, TX 75205-4899 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 01/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BP1-0023452 | INSTITUTIONAL PERMIT (01) |