MEDICARE: HECTOR MARTINEZ VIERA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YS0123X	Facial Plastic Surgery Physician	E5842	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00AK61	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1003941790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HECTOR MARTINEZ VIERA M.D.

Provider Business Mailing Address
First Line	:	2530 W HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1904
Country	:	US
Telephone Number	:	713-661-5255
Fax Number	:	713-661-7683

Provider Business Practice Location Address
First Line	:	2530 W HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1904
Country	:	US
Telephone Number	:	713-661-5255
Fax Number	:	713-661-7683

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	07/08/2007

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