Provider Demographics
NPI:1487973251
Name:XAVIER MARTINEZ M.D.,P.C.
Entity type:Organization
Organization Name:XAVIER MARTINEZ M.D.,P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:XAVIER
Authorized Official - Middle Name:V
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-622-7706
Mailing Address - Street 1:1701 W SAINT MARYS RD
Mailing Address - Street 2:SUITE 151
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2621
Mailing Address - Country:US
Mailing Address - Phone:520-622-7706
Mailing Address - Fax:520-622-4901
Practice Address - Street 1:1701 W SAINT MARYS RD
Practice Address - Street 2:SUITE 151
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2621
Practice Address - Country:US
Practice Address - Phone:520-622-7706
Practice Address - Fax:520-622-4901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18944174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
18944OtherSTATE LICENSE NUMBER
AZF27734Medicare UPIN