Provider Demographics
NPI:1104287382
Name:ISENBERG, ELSA CORTEZ
Entity type:Individual
Prefix:
First Name:ELSA
Middle Name:CORTEZ
Last Name:ISENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 SILVER MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5876
Mailing Address - Country:US
Mailing Address - Phone:956-572-4910
Mailing Address - Fax:
Practice Address - Street 1:1406 SILVER MAPLE LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5876
Practice Address - Country:US
Practice Address - Phone:956-572-4910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant