MEDICARE: ARACELI ELIZALDE MD

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
1	207K00000X	Allergy & Immunology Physician	P3620	TX

General Provider Information

NPI Number	:	1811174873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARACELI ELIZALDE MD

Provider Business Mailing Address
First Line	:	21727 IH 10 W
Second Line	:	STE 104
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-2108
Country	:	US
Telephone Number	:	210-899-6856
Fax Number	:	210-750-3056

Provider Business Practice Location Address
First Line	:	21727 IH 10 W
Second Line	:	STE 104
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-2108
Country	:	US
Telephone Number	:	210-704-4708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	02/27/2024

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