DR. JUAN CARLOS MARTINEZ GRULLON M.D. NPI 1154589950

NPI Information

  • NPI: 1154589950
  • Provider Name: DR. JUAN CARLOS MARTINEZ GRULLON, M.D.
  • Classification: Surgery - 2086S0122X
  • Specialization: Plastic and Reconstructive Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1250 8TH AVE STE 265
    FORT WORTH, TX
    ZIP 76104
  • Phone: (682) 200-8580

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NPI Details

DR. Juan Carlos Martinez Grullon, M.D. is a plastic and reconstructive surgery surgery in Fort Worth, TX. The provider is a surgeon who specializes in plastic and reconstructive surgery. DR. Juan Carlos Martinez Grullon, M.D. NPI is 1154589950. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1250 8TH AVE STE 265
FORT WORTH, TX
ZIP 76104-124
Phone: (682) 200-8580
Fax: (682) 200-8581

The NPI 1154589950 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/28/2008 and was last updated on 10/28/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic SurgeryMD448858PENNSYLVANIANo
2208200000XPlastic SurgeryT3999TEXASNo
32086S0122XSurgeryPlastic and Reconstructive SurgeryT3999TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10182590MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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