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General NPI Number Information
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NPI Number | 1902861644
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Entity Type | Individual
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Provider Name | ANTONIO EDUARDO MARTIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 11801 S. FREEWAY HUGULEY MEMORIAL HOSPITAL
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City | FORT WORTH
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State | TX
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Zip | 76115
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Country | US
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Telephone | 817-551-2743
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Fax |
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Provider Business Mailing Address
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Address Line | 8092 WINNERS CIR
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City | MANDEVILLE
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State | LA
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Zip | 70448-7513
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Country | US
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Telephone | 504-275-9555
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | K9346
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License Number State | TX
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