Provider Demographics
NPI:1396823795
Name:MAYNARD, LATOYA ELSA NADIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LATOYA
Middle Name:ELSA NADIA
Last Name:MAYNARD
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 1:1255 N POST OAK RD APT 7206
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7331
Mailing Address - Country:US
Mailing Address - Phone:832-607-4026
Mailing Address - Fax:
Practice Address - Street 1:13338 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-3129
Practice Address - Country:US
Practice Address - Phone:346-907-5550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8158207P00000X
CAA92833207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine