MEDICARE: MRS. MARITZA MARTINEZ-CHINCHILLA M.S.W., L.P.C.

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	101YP2500X	Professional Counselor	7954	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447430087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARITZA MARTINEZ-CHINCHILLA M.S.W., L.P.C.

Provider Business Mailing Address
First Line	:	PO BOX 57892
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-7892
Country	:	US
Telephone Number	:	832-646-5691
Fax Number	:

Provider Business Practice Location Address
First Line	:	991 BUOY RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-5119
Country	:	US
Telephone Number	:	832-646-5691
Fax Number	:

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

Provider Enumeration Date	:	11/12/2007
Last Update Date	:	11/12/2007

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