Provider Demographics
NPI:1891770343
Name:MCMURTRIE-JAYARAM, ELZBIETA B (MD)
Entity Type:Individual
Prefix:
First Name:ELZBIETA
Middle Name:B
Last Name:MCMURTRIE-JAYARAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7142 SAN PEDRO AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6254
Mailing Address - Country:US
Mailing Address - Phone:210-661-5622
Mailing Address - Fax:210-395-4012
Practice Address - Street 1:400 BALTIMORE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1919
Practice Address - Country:US
Practice Address - Phone:210-228-0743
Practice Address - Fax:210-228-9749
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2018-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL1388207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX390007584OtherMEDICARE RAILROAD
TX141228001Medicaid
TX141228001Medicaid
TXG65720Medicare UPIN