Provider Demographics
NPI:1053576371
Name:SAN MARTIN, JOSE EDUARDO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:EDUARDO
Last Name:SAN MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 ED ENGLISH DR. UNIT C
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385
Mailing Address - Country:US
Mailing Address - Phone:281-651-2090
Mailing Address - Fax:281-607-5700
Practice Address - Street 1:286 ED ENGLISH DR. UNIT C
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385
Practice Address - Country:US
Practice Address - Phone:281-651-2090
Practice Address - Fax:281-607-5700
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP84955390200000X
TXP3436207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program