Healthcare Provider Details

I. General information

NPI: 1992984280
Provider Name (Legal Business Name): J. ALEX MARTINEZ, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 BEE CAVE RD SUITE B 200
WEST LAKE HILLS TX
78746-6465
US

IV. Provider business mailing address

4201 BEE CAVE RD SUITE B 200
WEST LAKE HILLS TX
78746-6465
US

V. Phone/Fax

Practice location:
  • Phone: 512-478-9845
  • Fax: 512-478-3067
Mailing address:
  • Phone: 512-478-9845
  • Fax: 512-478-3067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberK1546
License Number StateTX

VIII. Authorized Official

Name: DR. JOSE ALEJANDRO MARTINEZ
Title or Position: DIRECTOR
Credential: M.D.
Phone: 512-478-9845