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NPI Code Detail

MEDICARE: DR. SHELBY DANIELLE MARTINEZ PHARMD

MEDICARE: DR. SHELBY DANIELLE MARTINEZ PHARMD
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
1183500000XPharmacist72589TX

General Provider Information

NPI Number : 1528831146
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHELBY DANIELLE MARTINEZ PHARMD
Provider Business Mailing Address
First Line : 1790 6TH ST
Second Line :
City : INGLESIDE
State : TX
Zip : 78362-6154
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1627 WILDCAT DR
Second Line :
City : PORTLAND
State : TX
Zip : 78374-2815
Country : US
Telephone Number : 361-643-1552
Fax Number : 361-777-0351
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2023
Last Update Date : 11/06/2023

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