Provider Demographics
NPI:1992984280
Name:J. ALEX MARTINEZ, M.D., P.A.
Entity type:Organization
Organization Name:J. ALEX MARTINEZ, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-478-9845
Mailing Address - Street 1:4201 BEE CAVE RD
Mailing Address - Street 2:SUITE B 200
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6465
Mailing Address - Country:US
Mailing Address - Phone:512-478-9845
Mailing Address - Fax:512-478-3067
Practice Address - Street 1:4201 BEE CAVE RD
Practice Address - Street 2:SUITE B 200
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6465
Practice Address - Country:US
Practice Address - Phone:512-478-9845
Practice Address - Fax:512-478-3067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1546261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D0504492OtherCLIA ID#
TXF83651Medicare UPIN