Provider Demographics
NPI:1699907345
Name:MAYBIN, ELIZABETH (MS, ATC, LAT)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:MAYBIN
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 SILVER LEAF CT
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3562
Mailing Address - Country:US
Mailing Address - Phone:254-295-4482
Mailing Address - Fax:254-295-5027
Practice Address - Street 1:4707 SILVER LEAF CT
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3562
Practice Address - Country:US
Practice Address - Phone:254-295-4482
Practice Address - Fax:254-295-4225
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer