Provider Demographics
NPI:1144780198
Name:MARTINEZ, ANGEL MARIE (BA, BSN, RN, CPN)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:MARIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:BA, BSN, RN, CPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10915 BURNING LAMP
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3242
Mailing Address - Country:US
Mailing Address - Phone:956-245-0590
Mailing Address - Fax:
Practice Address - Street 1:10915 BURNING LAMP
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3242
Practice Address - Country:US
Practice Address - Phone:956-245-0590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-24
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX932242163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics