MEDICARE: STEPHINE MARTINEZ

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	363LF0000X	Family Nurse Practitioner	926949	TX

General Provider Information

NPI Number	:	1811655640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHINE MARTINEZ

Provider Business Mailing Address
First Line	:	277 BUDDY GANEM DR STE A
Second Line	:
City	:	PORTLAND
State	:	TX
Zip	:	78374-3202
Country	:	US
Telephone Number	:	361-777-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 BROADFIELD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5163
Country	:	US
Telephone Number	:	914-919-9200
Fax Number	:	833-913-2393

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

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	04/14/2026

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Directions to “ STEPHINE MARTINEZ ” Practice Location

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