Provider Demographics
NPI:1710986112
Name:KIRALY, ELIZBETH MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZBETH
Middle Name:MARIE
Last Name:KIRALY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6600 FISH POND RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-2581
Mailing Address - Country:US
Mailing Address - Phone:254-776-3188
Mailing Address - Fax:254-776-3607
Practice Address - Street 1:6600 FISH POND RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-2581
Practice Address - Country:US
Practice Address - Phone:254-776-3188
Practice Address - Fax:254-776-3607
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL0340208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1710986112Medicare UPIN