MEDICARE: JORGE ANTONIO MARTINEZ D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	12325	TX

General Provider Information

NPI Number	:	1053752246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE ANTONIO MARTINEZ D.C.

Provider Business Mailing Address
First Line	:	14770 MEMORIAL DR
Second Line	:	SUITE 220
City	:	HOUSTON
State	:	TX
Zip	:	77079-5252
Country	:	US
Telephone Number	:	281-493-5535
Fax Number	:	281-493-3353

Provider Business Practice Location Address
First Line	:	13259 EAST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-5812
Country	:	US
Telephone Number	:	713-330-1530
Fax Number	:	713-330-1535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2013
Last Update Date	:	07/16/2013

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