Provider Demographics
NPI:1851331789
Name:M. ELIZABETH KLENZ MD PA
Entity Type:Organization
Organization Name:M. ELIZABETH KLENZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KLENZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-630-0240
Mailing Address - Street 1:1401 E RIDGE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1524
Mailing Address - Country:US
Mailing Address - Phone:956-630-0240
Mailing Address - Fax:956-630-1470
Practice Address - Street 1:1401 E RIDGE RD
Practice Address - Street 2:SUITE F
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1524
Practice Address - Country:US
Practice Address - Phone:956-630-0240
Practice Address - Fax:956-630-1470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8264173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG97847Medicare UPIN