Healthcare Provider Details

I. General information

NPI: 1306044292
Provider Name (Legal Business Name): TAMARA MARTINEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 GEMINI ST STE 128
HOUSTON TX
77058-2746
US

IV. Provider business mailing address

PO BOX 840853
DALLAS TX
75284-0853
US

V. Phone/Fax

Practice location:
  • Phone: 281-218-9515
  • Fax: 281-218-9534
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberTP243
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberN1802
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberE5524
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: