MEDICARE: JOE ALFRED MARTINEZ AG-ACNP

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	363L00000X	Nurse Practitioner	AP139828	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	394447202	OTHER	TX	CSHCN

General Provider Information

NPI Number	:	1760953509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE ALFRED MARTINEZ AG-ACNP

Provider Business Mailing Address
First Line	:	PO BOX 5730
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-5700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3011 W LOOP 1604 N STE 310
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-3963
Country	:	US
Telephone Number	:	210-598-5605
Fax Number	:	210-598-5620

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

Provider Enumeration Date	:	12/05/2018
Last Update Date	:	04/23/2026

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