Individual provider Active NPI

Gustavo Armando Martell, M.D.

  • Obstetrics & Gynecology Physician
  • El Paso, TX
National Provider Identifier
1659369395
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
J2185 Issued in TX
Practice address
11040 Vista del Sol Dr
Ste. a
El Paso, TX 79935-4314
Phone
(915) 591-4624
Fax
(915) 591-9291
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X J2185 TX Primary

Addresses

Primary practice location

11040 Vista del Sol Dr
Ste. a
El Paso, TX 79935-4314

Mailing address

11040 Vista del Sol Dr
Ste. a
El Paso, TX 79935-4314
Phone (915) 591-4624

Other identifiers 1

IdentifierTypeStateIssuer
116965801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J2185TXMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659369395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11040 VISTA DEL SOL DR",
            "address_2": "STE. A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799354314",
            "telephone_number": "915-591-4624",
            "fax_number": "915-591-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11040 VISTA DEL SOL DR",
            "address_2": "STE. A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799354314",
            "telephone_number": "915-591-4624",
            "fax_number": "915-591-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELL",
        "first_name": "GUSTAVO",
        "middle_name": "ARMANDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J2185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116965801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.