MEDICARE: IVONNE VEGA MARTINEZ MD

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1316820699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVONNE VEGA MARTINEZ MD

Provider Business Mailing Address
First Line	:	4200 N CHAI ST APT 613
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-0539
Country	:	US
Telephone Number	:	956-570-9852
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 S MCCOLL RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539
Country	:	US
Telephone Number	:	956-362-3505
Fax Number	:

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

Provider Enumeration Date	:	07/25/2025
Last Update Date	:	07/25/2025

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