Provider Demographics
NPI:1134445505
Name:SERRANO, MARIBEL (MD)
Entity type:Individual
Prefix:DR
First Name:MARIBEL
Middle Name:
Last Name:SERRANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 799
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-1921
Mailing Address - Country:US
Mailing Address - Phone:509-933-8720
Mailing Address - Fax:509-933-8722
Practice Address - Street 1:3270 JOE BATTLE BLVD STE 275
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2670
Practice Address - Country:US
Practice Address - Phone:915-271-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-10
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-12515207V00000X
WAMD60926856207V00000X, 207V00000X
TXU1213207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology