Provider Demographics
NPI:1124352711
Name:MARTINEZ, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MARTINEZ
Suffix:
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:PO BOX 40096
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-1096
Mailing Address - Country:US
Mailing Address - Phone:210-792-4410
Mailing Address - Fax:210-647-8009
Practice Address - Street 1:5504 BANDERA RD STE 617
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1947
Practice Address - Country:US
Practice Address - Phone:210-792-4410
Practice Address - Fax:210-647-8009
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000323341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance