Provider Demographics
NPI:1487305975
Name:MARTINEZ, PABLO SOLIZ III
Entity type:Individual
Prefix:MR
First Name:PABLO
Middle Name:SOLIZ
Last Name:MARTINEZ
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 SARATOGA BLVD APT 332
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2267
Mailing Address - Country:US
Mailing Address - Phone:361-537-5813
Mailing Address - Fax:
Practice Address - Street 1:4646 CORONA DR STE 158
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4320
Practice Address - Country:US
Practice Address - Phone:361-945-3084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health