Provider Demographics
NPI:1578036802
Name:MARTINEZ, JAVIER EDUARDO (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:EDUARDO
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E REDD RD FL 2
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-1981
Mailing Address - Country:US
Mailing Address - Phone:915-584-4200
Mailing Address - Fax:915-338-2457
Practice Address - Street 1:121 E REDD RD FL 2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-1981
Practice Address - Country:US
Practice Address - Phone:915-584-4200
Practice Address - Fax:915-338-2457
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14444363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant