Martinez, Gustavo R

Martinez, Gustavo R is an individual health care provider with primary practice located at 814 Myrtle Ave , El Paso TX 79901-1512. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Martinez, Gustavo R can be contacted via phone (915) 241-7272.

Contact Information

Primary practice address
814 Myrtle Ave El Paso TX 79901-1512
Fax: (877) 587-9452
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 01545 Texas

Profile Details

NPI number 1154397651
LBN Legal business name Martinez, Gustavo R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Nov 14th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1154397651 NPPES
Texas Other 88048Q BCBS
Texas MEDICAID 071353903 BCBS

Popular Providers