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NPI Code Detail

MEDICARE: GUSTAVO MARTINEZ JR.

MEDICARE: GUSTAVO MARTINEZ JR.
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
1106S00000XBehavior TechnicianTX

General Provider Information

NPI Number : 1326916180
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUSTAVO MARTINEZ JR.
Provider Business Mailing Address
First Line : 6222 W IH 10 STE 104
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-2013
Country : US
Telephone Number : 210-447-0039
Fax Number :
Provider Business Practice Location Address
First Line : 864 CENTRAL BLVD STE 2900
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78520-7594
Country : US
Telephone Number : 210-447-0039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2025
Last Update Date : 10/28/2025

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Directions to “ GUSTAVO MARTINEZ JR. ” Practice Location

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