Provider Demographics
NPI:1427257872
Name:JUAREZ, ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:JUAREZ
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 1:512 VICTORIA LN STE 12
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3228
Mailing Address - Country:US
Mailing Address - Phone:956-440-6300
Mailing Address - Fax:888-698-3908
Practice Address - Street 1:5501 S EXPRESSWAY 77
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3213
Practice Address - Country:US
Practice Address - Phone:956-365-1023
Practice Address - Fax:956-365-1823
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6054636-1205207R00000X
TXM6686208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
8AK888OtherBCBS OF TX
TX190854303Medicaid
TX0069KVOtherGROUP BCBS OF TX
TX00171WOtherGROUP MEDICARE
TX00171WOtherGROUP MEDICARE
TX0069KVOtherGROUP BCBS OF TX
TXTXB146765Medicare PIN