Provider Demographics
NPI:1033581947
Name:ELIZONDO, MARIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:ELIZONDO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 ROBIN AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4203
Mailing Address - Country:US
Mailing Address - Phone:956-207-4313
Mailing Address - Fax:956-618-5193
Practice Address - Street 1:2408 ROBIN AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4203
Practice Address - Country:US
Practice Address - Phone:956-207-4313
Practice Address - Fax:956-618-5193
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX787822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse