Provider Demographics
NPI:1366258352
Name:MARTINEZ, ABRAHAM (NP)
Entity type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:ABRAHAM
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2000 TRANSMOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79911-3601
Mailing Address - Country:US
Mailing Address - Phone:915-877-8473
Mailing Address - Fax:
Practice Address - Street 1:1601 E YANDELL DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5677
Practice Address - Country:US
Practice Address - Phone:866-484-8049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1180835363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health