Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | P7502 | TX |
N | 207VX0000X | Obstetrician | P7502 | TX |
NPI | 1326364381 |
---|---|
Provider Name | Oscar Martinez JR. |
First Address | Tahoka, TX 79373-4118 |
Second Address | Tahoka, TX 79373-4118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2010 |
Last Update Date | 31/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
326932601 | (05) | TX |