Healthcare Provider Details

I. General information

NPI: 1376326884
Provider Name (Legal Business Name): ANTHONY STEVEN MARTINEZ PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 MONTGOMERY PKWY NE # 2H
ALBUQUERQUE NM
87111-3876
US

IV. Provider business mailing address

PO BOX 7572
SPRING TX
77387-7572
US

V. Phone/Fax

Practice location:
  • Phone: 346-730-6827
  • Fax: 888-414-9764
Mailing address:
  • Phone: 832-868-9458
  • Fax: 888-414-9764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1130606
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number327530
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number84696
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number115410-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: