Provider Demographics
NPI:1285908640
Name:MARTINEZ, ANA MARIA (LVN)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5047 SHERRI ANN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-6213
Mailing Address - Country:US
Mailing Address - Phone:210-828-2503
Mailing Address - Fax:210-828-0590
Practice Address - Street 1:4330 MEDICAL DRIVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3353
Practice Address - Country:US
Practice Address - Phone:210-828-2503
Practice Address - Fax:210-828-0590
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193795164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse