Provider Demographics
NPI:1316287733
Name:ECHIVERRI, MARIA JOSEFINA ABALOS (NP)
Entity type:Individual
Prefix:
First Name:MARIA JOSEFINA
Middle Name:ABALOS
Last Name:ECHIVERRI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARIA JOSEFINA
Other - Middle Name:ABALOS
Other - Last Name:ECHIVERRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5806 SAN MARINO DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-4557
Mailing Address - Country:US
Mailing Address - Phone:214-517-5861
Mailing Address - Fax:
Practice Address - Street 1:3430 LAKEVIEW PKWY
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088
Practice Address - Country:US
Practice Address - Phone:972-475-2597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX759992363LF0000X
TXAP123138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX320890201Medicaid