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General NPI Number Information
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NPI Number | 1679947626
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Entity Type | Organization
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Legal Business Name | JUAN J MARTIN MD PLLC
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Dates
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Enumeration Date | 11/13/2015
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 8811 VILLAGE DR SUITE 301
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5415
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Country | US
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Telephone | 210-229-7234
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Fax | 210-229-7235
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Provider Business Mailing Address
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Address Line | 100 N SANTA ROSA ST #728
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City | SAN ANTONIO
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State | TX
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Zip | 78207-3205
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Country | US
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Telephone | 210-229-7234
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Fax | 210-229-7235
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Authorized Official
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Title or Position | OWNER
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Name | JUAN J MARTIN
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Credential | MD
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Telephone | 210-365-6171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | Q0504
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License Number State | TX
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