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NPI 1902155864

NPI 1902155864 : MARTIN L YAMZON FNP : FORT SAM HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1902155864
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    Entity Type          |    Individual 
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    Provider Name        |    MARTIN L YAMZON FNP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/06/2012
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    Last Update Date     |    02/10/2025
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Provider Practice Location Address
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    Address Line         |    3551 ROGER BROOKE DR 
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    City                 |    FORT SAM HOUSTON
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    State                |    TX
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    Zip                  |    78234-4504
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    Country              |    US
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    Telephone            |    210-916-3000
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    Fax                  |    210-539-2075
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Provider Business Mailing Address
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    Address Line         |    3551 ROGER BROOKE DR 
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    City                 |    FORT SAM HOUSTON
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    State                |    TX
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    Zip                  |    78234-4504
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    Country              |    US
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    Telephone            |    210-916-3000
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    Fax                  |    210-539-2075
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    7658246
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    License Number State |    TX
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