Provider Demographics
NPI:1467742601
Name:ELIZONDO, YASMIN
Entity Type:Individual
Prefix:MS
First Name:YASMIN
Middle Name:
Last Name:ELIZONDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 E HARRISON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7309
Mailing Address - Country:US
Mailing Address - Phone:956-756-2553
Mailing Address - Fax:
Practice Address - Street 1:1610 E HARRISON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7309
Practice Address - Country:US
Practice Address - Phone:956-756-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist