Provider Demographics
NPI:1790580710
Name:MARTINEZ CAMPOS, URIEL NARSES
Entity type:Individual
Prefix:
First Name:URIEL
Middle Name:NARSES
Last Name:MARTINEZ CAMPOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 MCCOMBS RD
Mailing Address - Street 2:
Mailing Address - City:CHAPARRAL
Mailing Address - State:NM
Mailing Address - Zip Code:88081-7937
Mailing Address - Country:US
Mailing Address - Phone:575-824-3454
Mailing Address - Fax:575-824-3071
Practice Address - Street 1:317 MCCOMBS RD
Practice Address - Street 2:
Practice Address - City:CHAPARRAL
Practice Address - State:NM
Practice Address - Zip Code:88081-7937
Practice Address - Country:US
Practice Address - Phone:575-824-3454
Practice Address - Fax:575-824-3071
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMG-1372172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker