Provider Demographics
NPI:1265639777
Name:MARTIN, JUAN J (MD)
Entity type:Individual
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First Name:JUAN
Middle Name:J
Last Name:MARTIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11301 FALLBROOK DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4237
Mailing Address - Country:US
Mailing Address - Phone:281-653-2686
Mailing Address - Fax:281-653-2938
Practice Address - Street 1:11301 FALLBROOK DR
Practice Address - Street 2:SUITE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4237
Practice Address - Country:US
Practice Address - Phone:281-653-2686
Practice Address - Fax:281-653-2938
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2017-02-13
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Provider Licenses
StateLicense IDTaxonomies
TXQ0504207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery