Provider Demographics
NPI:1447467436
Name:GEORGE D MARTINEZ MD INC
Entity type:Organization
Organization Name:GEORGE D MARTINEZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-250-5577
Mailing Address - Street 1:13450 N HWY 183
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-3239
Mailing Address - Country:US
Mailing Address - Phone:512-250-5577
Mailing Address - Fax:512-250-5590
Practice Address - Street 1:13729 RESEARCH BLVD
Practice Address - Street 2:SUITE 890
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2268
Practice Address - Country:US
Practice Address - Phone:512-250-5577
Practice Address - Fax:512-250-5590
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEORGE D MARTINEZ MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-17
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6912207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82A262OtherBCBS
TX00FX66Medicare PIN
TX82A262OtherBCBS
TX00FX66Medicare ID - Type Unspecified