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General NPI Number Information
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NPI Number | 1598055063
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Entity Type | Individual
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Provider Name | CHRISTOPHER JAVIER MARTINEZ DDS
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Gender | Male
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Dates
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Enumeration Date | 04/18/2011
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 3509 E MAIN AVE STE 103
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City | ALTON
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State | TX
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Zip | 78573-1562
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Country | US
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Telephone | 565-839-6019
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Fax | 956-583-9603
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Provider Business Mailing Address
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Address Line | 10124 N GLASSCOCK RD
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City | MISSION
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State | TX
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Zip | 78573-5910
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Country | US
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Telephone | 210-422-1141
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 26120
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License Number State | TX
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