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General NPI Number Information
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NPI Number | 1053989384
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Entity Type | Individual
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Provider Name | MARIA DE JESUS MARTINEZ-HERNANDEZ OTR, MOT
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Gender | Female
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 8627 LAKESIDE PKWY
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City | SAN ANTONIO
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State | TX
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Zip | 78245-3261
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Country | US
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Telephone | 210-810-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 10803 SIERRA GLEN DR
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City | SAN ANTONIO
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State | TX
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Zip | 78245-2771
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Country | US
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Telephone | 210-606-7090
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 111250
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License Number State | TX
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