Individual provider · NPI-1
Jerry Martinez, cota
Contractor · Alton, TX
NPI number1003269440
StatusActive
Last updated in NPPESJul 21, 2016
Details
- NPI
- 1003269440
- Entity type
- Individual (NPI-1)
- Name
- Jerry Martinez
- Credential
- cota
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 21, 2016
- Last updated
- Jul 21, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | 209135 | TX | Yes |
Practice location
921 E Main Ave Ste 5Alton, TX 78573-1606
Phone 956-519-2500
Mailing address
921 E Main Ave Ste 5Alton, TX 78573-1606
Phone 956-519-2500
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