Individual provider Active NPI

David Alonso Martinez, OD

  • Optometrist
  • Laredo, TX
National Provider Identifier
1477175065
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10053TG Issued in TX
Practice address
2329 Jacaman Rd Ste 15
Laredo, TX 78041-6264
Phone
(956) 753-7373
NPI assigned
May 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10053TG TX Primary

Addresses

Primary practice location

2329 Jacaman Rd Ste 15
Laredo, TX 78041-6264

Mailing address

2329 Jacaman Rd Ste 15
Laredo, TX 78041-6264
Phone (956) 753-7373

Other identifiers 1

IdentifierTypeStateIssuer
426214901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210721002576 TX Practitioner - Optometry 8628471133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flores Eye Care Clinic, PCGroup PAC ID 2365512274, 3 clinicians

Practice addresses (Care Compare)

2329 Jacaman Rd
Suite 15
Laredo, TX 78041-6264
Phone (956) 753-7373

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10053TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Flores Eye Care Clinic, PC Optometrist CurrentSince Jul 14, 2021 Accepting new patients
Timithy M Dunham MD PA Optometrist PastSince Jul 14, 2021 Accepting new patients

Locations

2329 Jacaman Rd
Ste 15
Laredo, TX 78041
Phone (956) 286-5410

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1477175065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 JACAMAN RD STE 15",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416264",
            "telephone_number": "956-753-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 JACAMAN RD STE 15",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416264",
            "telephone_number": "956-753-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "DAVID",
        "middle_name": "ALONSO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10053TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426214901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.