Martinez, Lisa

Martinez, Lisa is an individual health care provider with primary practice located at 815 Pennsylvania Ave , Fort Worth TX 76104-2224. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Martinez, Lisa can be contacted via phone (817) 321-0387.

Contact Information

Primary practice address
815 Pennsylvania Ave Fort Worth TX 76104-2224
Phone: (817) 321-0387
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X H8235 Texas

Profile Details

NPI number 1255331120
LBN Legal business name Martinez, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Aug 15th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255331120 NPPES
Texas MEDICAID 138696314
Texas MEDICAID 1386963-16
Texas MEDICAID 138696310

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