Healthcare Provider Details

I. General information

NPI: 1811235609
Provider Name (Legal Business Name): RGV FAMILY DENTISTRY BY LUZ E MARTINEZ DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 JAMES STREET SUITE G
WESLACO TX
78596
US

IV. Provider business mailing address

909 JAMES STREET SUITE G
WESLACO TX
78596
US

V. Phone/Fax

Practice location:
  • Phone: 956-968-3300
  • Fax: 956-968-3306
Mailing address:
  • Phone: 956-968-3300
  • Fax: 956-968-3306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number25435
License Number StateTX

VIII. Authorized Official

Name: DR. LUZ E MARTINEZ
Title or Position: OWNER / DENTIST
Credential: DDS
Phone: 956-968-3300