Provider Demographics
NPI:1780777326
Name:MARTINEZ, DENISE M (PHARM D, RPH)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 LAKES AT 610 DR
Mailing Address - Street 2:ATTN: PHARMACY ADMINISTRATION
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2525
Mailing Address - Country:US
Mailing Address - Phone:713-442-6248
Mailing Address - Fax:713-442-5253
Practice Address - Street 1:8900 LAKES AT 610 DR
Practice Address - Street 2:PHARMACY ADMINISTRATION
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-442-6248
Practice Address - Fax:713-442-5253
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist