MEDICARE: CATALINA ZAMBRANO MARTINEZ DDS, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	35079	TX

General Provider Information

NPI Number	:	1255999884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATALINA ZAMBRANO MARTINEZ DDS, MS

Provider Business Mailing Address
First Line	:	217 ASTER TRL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-1621
Country	:	US
Telephone Number	:	210-331-1298
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 W LOUIS HENNA BLVD STE 110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78728-1702
Country	:	US
Telephone Number	:	512-593-7970
Fax Number	:

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

Provider Enumeration Date	:	05/29/2019
Last Update Date	:	05/29/2019

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