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NPI Code Detail

MEDICARE: ISSIS N ELVIR

MEDICARE:   ISSIS N ELVIR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA19448TX

General Provider Information

NPI Number : 1063390565
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISSIS N ELVIR
Provider Business Mailing Address
First Line : 4801 WOODWAY DR STE 306W
Second Line :
City : HOUSTON
State : TX
Zip : 77056-1828
Country : US
Telephone Number : 201-903-6155
Fax Number : 201-903-6155
Provider Business Practice Location Address
First Line : 4801 WOODWAY DR STE 306W
Second Line :
City : HOUSTON
State : TX
Zip : 77056-1828
Country : US
Telephone Number : 832-225-3345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2025
Last Update Date : 09/15/2025

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Directions to “ ISSIS N ELVIR ” Practice Location

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