Provider Demographics
NPI:1861422909
Name:MARTINEZ, SANTOS J JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:SANTOS
Middle Name:J
Last Name:MARTINEZ
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1323 E FRANKLIN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:HILLSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76645-2679
Mailing Address - Country:US
Mailing Address - Phone:972-957-3000
Mailing Address - Fax:972-236-0096
Practice Address - Street 1:3247 DAWES DR.
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211
Practice Address - Country:US
Practice Address - Phone:214-330-7767
Practice Address - Fax:214-330-7780
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2020-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03431363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP77675Medicare UPIN
8L11411Medicare PIN
TX8J7748Medicare PIN
TX8J7747Medicare PIN