MEDICARE: MARTIN J. CITARDI MD

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	207Y00000X	Otolaryngology Physician	35078802C	OH
2	207Y00000X	Otolaryngology Physician	M8607	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	040015678	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8BD690	OTHER	TX	BCBSTX
4	M8607 207Y00000X	OTHER	TX	TX LICENSE & PRIMARY TAXOMONY
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578527214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN J. CITARDI MD

Provider Business Mailing Address
First Line	:	6431 FANNIN STREET, MSB 5.036
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030
Country	:	US
Telephone Number	:	713-500-0541
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 FANNIN ST
Second Line	:	SUITE 2700
City	:	HOUSTON
State	:	TX
Zip	:	77030-1521
Country	:	US
Telephone Number	:	713-465-5000
Fax Number	:	713-383-1410

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	10/30/2022

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Directions to “ MARTIN J. CITARDI MD” Practice Location

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