MEDICARE: DR. OSCAR MARIO MARTINEZ III D.D.S.

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	122300000X	Dentist	25637	TX

General Provider Information

NPI Number	:	1588976153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OSCAR MARIO MARTINEZ III D.D.S.

Provider Business Mailing Address
First Line	:	4818 LYCEUM DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-5038
Country	:	US
Telephone Number	:	210-400-6363
Fax Number	:

Provider Business Practice Location Address
First Line	:	6018 WEST AVE
Second Line	:	SUITE #2
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-2729
Country	:	US
Telephone Number	:	408-835-3726
Fax Number	:

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

Provider Enumeration Date	:	07/11/2010
Last Update Date	:	07/11/2010

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