NPIMap

Organization Active NPI

Henry E. Martinez MD, PA

  • Specialist
  • Lake Jackson, TX
National Provider Identifier
1669696738
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HENRY E. MARTINEZ MD, PA
Practice address
201 Oak Dr S
Suite 202
Lake Jackson, TX 77566-5676
Phone
(979) 297-3098
NPI assigned
Apr 12, 2007
Last updated
Oct 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Authorized official

Name
Dr. Henry Enoc Martinez, MDNPI 1447248125
Title
Owner
Phone
(979) 297-3098

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

201 Oak Dr S
Suite 202
Lake Jackson, TX 77566-5676

Mailing address

201 Oak Dr S
Suite 202
Lake Jackson, TX 77566-5676
Phone (979) 297-3098

Other identifiers 4

IdentifierTypeStateIssuer
0001OtherTXGP ID FOR TRICARE
165446901MedicaidTX
0061KZOtherTXGROUP ID FOR BCBS
DC2985OtherTXGP ID# RAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040609001452 TX Part B Supplier - Clinic/Group Practice 0547243602 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Jackson, TX

National Provider Directory

National Provider Directory

Locations

201 Oak Dr S
Ste 202
Lake Jackson, TX 77566
Phone (979) 285-9995

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1669696738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OAK DR S",
            "address_2": "SUITE 202",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665676",
            "telephone_number": "979-297-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OAK DR S",
            "address_2": "SUITE 202",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665676",
            "telephone_number": "979-297-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY E. MARTINEZ MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "ENOC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-297-3098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GP ID FOR TRICARE",
            "identifier": "0001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165446901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID FOR BCBS",
            "identifier": "0061KZ",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GP ID# RAILROAD MEDICARE",
            "identifier": "DC2985",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.