Provider Demographics
NPI:1124878608
Name:BARRERA ELIZONDO, MARIA CECILIA (FNP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CECILIA
Last Name:BARRERA ELIZONDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:TX
Mailing Address - Zip Code:78516-0339
Mailing Address - Country:US
Mailing Address - Phone:956-353-9580
Mailing Address - Fax:
Practice Address - Street 1:1301 W SAM HOUSTON BLVD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5668
Practice Address - Country:US
Practice Address - Phone:956-702-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1156075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine