Provider Demographics
NPI:1962565044
Name:RICARDO MARTINEZ DC PC
Entity type:Organization
Organization Name:RICARDO MARTINEZ DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:361-884-6609
Mailing Address - Street 1:2300 BALDWIN BLVD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-2012
Mailing Address - Country:US
Mailing Address - Phone:361-884-6609
Mailing Address - Fax:361-884-7317
Practice Address - Street 1:2300 BALDWIN BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-2012
Practice Address - Country:US
Practice Address - Phone:361-884-6609
Practice Address - Fax:361-884-7317
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICARDO MARTINEZ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-19
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001179301Medicaid
TX0A5993Medicare PIN
TX001179301Medicaid