Provider Demographics
NPI:1144723859
Name:MARTINEZ, ANGELICA (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 N VETERANS BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4456
Mailing Address - Country:US
Mailing Address - Phone:830-776-5998
Mailing Address - Fax:855-881-1464
Practice Address - Street 1:1975 N VETERANS BLVD STE 3
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4456
Practice Address - Country:US
Practice Address - Phone:830-776-5998
Practice Address - Fax:855-881-1464
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-09
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily