MEDICARE: JAVIER EDUARDO MARTINEZ PHYSICIAN ASSISTANT

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	363A00000X	Physician Assistant	PA14444	TX

General Provider Information

NPI Number	:	1578036802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAVIER EDUARDO MARTINEZ PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	121 E REDD RD FL 2
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-1981
Country	:	US
Telephone Number	:	915-584-4200
Fax Number	:	915-338-2457

Provider Business Practice Location Address
First Line	:	121 E REDD RD FL 2
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-1981
Country	:	US
Telephone Number	:	915-584-4200
Fax Number	:	915-338-2457

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

Provider Enumeration Date	:	01/09/2019
Last Update Date	:	05/29/2025

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