MEDICARE: HERNAN ALONSO MARTINEZ ARNP

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	363LF0000X	Family Nurse Practitioner	849073	TX

General Provider Information

NPI Number	:	1659623825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERNAN ALONSO MARTINEZ ARNP

Provider Business Mailing Address
First Line	:	78 N KNIGHTS CROSSING DR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-1493
Country	:	US
Telephone Number	:	305-281-7578
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 ST JOSEPH PKWY STE 1309
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8236
Country	:	US
Telephone Number	:	832-366-1305
Fax Number	:

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

Provider Enumeration Date	:	10/11/2012
Last Update Date	:	01/17/2016

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