Carlos Risik Martinez Licha, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME159487 Issued in FL

Practice address

San Antonio Military Medical Center, McHe-ZDM-M
Internal Medicine Residency, 3551 Roger Brooke Dr.
Jbsa-Fort Sam Houston, TX 78234-4504

Phone

(210) 916-5000

Fax

(210) 916-2077

NPI assigned

Apr 2, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1275112864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-M",
            "address_2": "INTERNAL MEDICINE RESIDENCY, 3551 ROGER BROOKE DR.",
            "city": "JBSA-FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-5000",
            "fax_number": "210-916-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-M",
            "address_2": "INTERNAL MEDICINE RESIDENCY, 3551 ROGER BROOKE DR.",
            "city": "JBSA-FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-5000",
            "fax_number": "210-916-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ LICHA",
        "first_name": "CARLOS",
        "middle_name": "RISIK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME159487",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME159487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hana Kathleen Kwan, MD
• Cory Madigan, MD
• Kellin K Mair, DO
• Robert Kevin Manning, PH.D, CCC-SLP
• James John Marsh VI, MD
• Hunter William McCollum, MD
• Aaron Matthew McGuire
• Andres M Mendoza, DDS
• Mary Katherine Miller, MD
• Rebecca Lynn Morrell, PT, DPT

• Internal Medicine Physician in Jbsa-Fort Sam Houston, TX
• Providers in Jbsa-Fort Sam Houston, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.