Dr. Carlos Risik Martinez Licha, MD
Internal Medicine in Jbsa-Fort Sam Houston, TX. Individual provider (NPI-1).
NPI number1275112864
StatusActive
Last updated in NPPESDec 19, 2024
Details
- NPI
- 1275112864
- Entity type
- Individual (NPI-1)
- Name
- Dr. Carlos Risik Martinez Licha
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 2, 2021
- Certification date
- Dec 19, 2024
- Last updated
- Dec 19, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - INTERNAL MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | ME159487 | FL | Yes |
| 208D00000X | General Practice | ME159487 | FL |
Practice location
San Antonio Military Medical Center, Mche-Zdm-MInternal Medicine Residency, 3551 Roger Brooke Dr.
Jbsa-Fort Sam Houston, TX 78234-4504
Phone 210-916-5000 · Fax 210-916-2077
Mailing address
San Antonio Military Medical Center, Mche-Zdm-MInternal Medicine Residency, 3551 Roger Brooke Dr.
Jbsa-Fort Sam Houston, TX 78234-4504
Phone 210-916-5000 · Fax 210-916-2077
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