Healthcare Provider Details

I. General information

NPI: 1760428809
Provider Name (Legal Business Name): ONEIDA ELIZONDO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5416 S JACKSON RD
EDINBURG TX
78539-8326
US

IV. Provider business mailing address

502 S CLOSNER BLVD
EDINBURG TX
78539-4660
US

V. Phone/Fax

Practice location:
  • Phone: 956-686-6050
  • Fax: 956-686-6359
Mailing address:
  • Phone: 956-292-0100
  • Fax: 956-292-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number638813
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: