Provider Demographics
NPI:1417179433
Name:MARTINEZ, MARIA ANITA (RPH, CDE)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ANITA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RPH, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 BURNING HILL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3805
Mailing Address - Country:US
Mailing Address - Phone:210-827-4449
Mailing Address - Fax:
Practice Address - Street 1:2819 BURNING HILL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3805
Practice Address - Country:US
Practice Address - Phone:210-827-4449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240251835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy