Provider Demographics
NPI:1023298304
Name:EMANUEL E. MARTINEZ M.D., P.A.
Entity type:Organization
Organization Name:EMANUEL E. MARTINEZ M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMANUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:956-722-6777
Mailing Address - Street 1:7210 MCPHERSON RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6507
Mailing Address - Country:US
Mailing Address - Phone:956-722-6777
Mailing Address - Fax:
Practice Address - Street 1:7210 MCPHERSON RD
Practice Address - Street 2:STE. 200
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6507
Practice Address - Country:US
Practice Address - Phone:956-722-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6409208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0099QNOtherBC/BS
TX8AJ710OtherBC/BS