Healthcare Provider Details

I. General information

NPI: 1538486451
Provider Name (Legal Business Name): JOSE LUIS MARTINEZ JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2010
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18951 N MEMORIAL DR
HUMBLE TX
77338-4217
US

IV. Provider business mailing address

1140 BUSINESS CENTER DR STE 201
HOUSTON TX
77043-2744
US

V. Phone/Fax

Practice location:
  • Phone: 281-540-7700
  • Fax:
Mailing address:
  • Phone: 713-932-5757
  • Fax: 713-932-5750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP5418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: