MEDICARE: GUILLERMINA MARTINEZ LVN

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	164X00000X	Licensed Vocational Nurse	331515	TX

General Provider Information

NPI Number	:	1790241636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILLERMINA MARTINEZ LVN

Provider Business Mailing Address
First Line	:	2522 BUDDY OWENS AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-5464
Country	:	US
Telephone Number	:	956-630-1116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1116 PALM AVE
Second Line	:
City	:	LA FERIA
State	:	TX
Zip	:	78559-5119
Country	:	US
Telephone Number	:	956-330-0078
Fax Number	:

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

Provider Enumeration Date	:	02/15/2019
Last Update Date	:	02/15/2019

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