Healthcare Provider Details

I. General information

NPI: 1629612742
Provider Name (Legal Business Name): EMILY YVONNE MARTINEZ FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11398 BANDERA RD STE 201
SAN ANTONIO TX
78250-6827
US

IV. Provider business mailing address

14100 SAN PEDRO AVE STE 412
SAN ANTONIO TX
78232-2009
US

V. Phone/Fax

Practice location:
  • Phone: 210-998-4751
  • Fax: 210-543-7338
Mailing address:
  • Phone: 210-281-8669
  • Fax: 210-314-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP143785
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP143785
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: