Healthcare Provider Details

I. General information

NPI: 1912913658
Provider Name (Legal Business Name): CARLA A MARTINEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CEDAR ST SE STE 405
ALBUQUERQUE NM
87106-4924
US

IV. Provider business mailing address

201 CEDAR ST SE STE 405
ALBUQUERQUE NM
87106-4924
US

V. Phone/Fax

Practice location:
  • Phone: 505-764-9535
  • Fax: 505-217-3402
Mailing address:
  • Phone: 505-764-9535
  • Fax: 505-217-3402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD2012-0852
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberM3635
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberM3635
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD2012-0852
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: