Provider Demographics
NPI:1871984807
Name:BUENO MARTINEZ, NORMA ALEJANDRA (MD)
Entity type:Individual
Prefix:
First Name:NORMA ALEJANDRA
Middle Name:
Last Name:BUENO MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 W MEDICAL CENTER BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4240
Mailing Address - Country:US
Mailing Address - Phone:713-486-1590
Mailing Address - Fax:713-486-1594
Practice Address - Street 1:561 W MEDICAL CENTER BLVD STE A
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4240
Practice Address - Country:US
Practice Address - Phone:713-486-1590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT61992080P0202X
FLME1357672080P0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMTN981382004OtherBLUECROSS BLUE SHIELD OF MASSACHUSETTS