Provider Demographics
NPI:1538553383
Name:MARTINEZ, TAMRA HERSHEL
Entity type:Individual
Prefix:
First Name:TAMRA
Middle Name:HERSHEL
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMRA
Other - Middle Name:RENEE
Other - Last Name:HERSHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13839 HORSETAIL TER
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-7606
Mailing Address - Country:US
Mailing Address - Phone:719-772-6060
Mailing Address - Fax:
Practice Address - Street 1:13839 HORSETAIL TER
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-7606
Practice Address - Country:US
Practice Address - Phone:719-772-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor