Provider Demographics
NPI:1316267461
Name:MARTINEZ, KRIS (PA)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 57845
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-7845
Mailing Address - Country:US
Mailing Address - Phone:812-484-5587
Mailing Address - Fax:281-484-1785
Practice Address - Street 1:10950 RESOURCE PARKWAY
Practice Address - Street 2:STE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089
Practice Address - Country:US
Practice Address - Phone:281-484-5587
Practice Address - Fax:281-484-1785
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA02446363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant