MEDICARE: RAUL GERARDO MARTINEZ M.D.

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	208VP0000X	Pain Medicine Physician	J9906	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538168703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAUL GERARDO MARTINEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2208
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78298-2208
Country	:	US
Telephone Number	:	210-805-9800
Fax Number	:	210-805-8770

Provider Business Practice Location Address
First Line	:	3202 CHERRY RIDGE DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-4806
Country	:	US
Telephone Number	:	210-441-4333
Fax Number	:	210-441-4330

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	05/12/2023

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