Provider Demographics
NPI:1750333167
Name:ESTRONZA, NORDELI (MD)
Entity Type:Individual
Prefix:
First Name:NORDELI
Middle Name:
Last Name:ESTRONZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NORDELI
Other - Middle Name:
Other - Last Name:ESTRONZA CAPPAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-2111
Mailing Address - Fax:
Practice Address - Street 1:2600 E PFLUGERVILLE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-5999
Practice Address - Country:US
Practice Address - Phone:512-654-6500
Practice Address - Fax:512-654-6501
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME813192084N0400X, 2084N0400X
NE317852084N0400X, 2084N0400X
MI43011193152084N0400X, 2084N0400X
VA01012254852084N0400X, 2084N0400X
TXP84662084N0400X
GA837222084N0400X
TN595512084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG75034Medicare UPIN