Provider Demographics
NPI:1346212180
Name:NAVARRO, MARITZA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARITZA
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 SETON CENTER PKWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5290
Mailing Address - Country:US
Mailing Address - Phone:737-247-7200
Mailing Address - Fax:512-406-7368
Practice Address - Street 1:11714 WILSON PARKE AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-4006
Practice Address - Country:US
Practice Address - Phone:737-247-7200
Practice Address - Fax:512-406-7368
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0953207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX364156YKXYOtherMEDICARE WILLIAMSON COUNTY
TX8S6520OtherBCBS OF TEXAS INDIVIDUAL #
TX364156YKXVOtherMEDICARE TRAVIS COUNTY
TXG31218Medicare UPIN
TX8S6520OtherBCBS OF TEXAS INDIVIDUAL #