Provider Demographics
NPI:1134396864
Name:FERNANDEZ-ARIAS, ELIZABETH (DPM)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:FERNANDEZ-ARIAS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:1576 LOMALAND DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-4202
Mailing Address - Country:US
Mailing Address - Phone:915-995-1650
Mailing Address - Fax:915-995-1650
Practice Address - Street 1:1576 LOMALAND
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935
Practice Address - Country:US
Practice Address - Phone:915-995-1650
Practice Address - Fax:915-995-1650
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1855213ES0103X, 332B00000X
FLPO 3279213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0060AZOtherMEDICAR/PTAN
TXPD458Medicaid
TXPD458Medicaid