Provider Demographics
NPI:1699663112
Name:LIZARAZO MIKLY, JAVIER FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:FRANCISCO
Last Name:LIZARAZO MIKLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E DOVE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3974
Mailing Address - Country:US
Mailing Address - Phone:956-362-3505
Mailing Address - Fax:
Practice Address - Street 1:1000 E DOVE AVE STE 200
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3974
Practice Address - Country:US
Practice Address - Phone:956-362-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program