Provider Demographics
NPI:1255546453
Name:MARQUEZ, LIZBET (MMS PA-C)
Entity type:Individual
Prefix:MRS
First Name:LIZBET
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:MMS PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 JOE BATTLE BLVD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2622
Mailing Address - Country:US
Mailing Address - Phone:915-832-2000
Mailing Address - Fax:
Practice Address - Street 1:3280 JOE BATTLE BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2622
Practice Address - Country:US
Practice Address - Phone:915-832-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19167363AM0700X
TXPA04709363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical