Healthcare Provider Details

I. General information

NPI: 1205744679
Provider Name (Legal Business Name): ELIZABETH CISNEROS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 TX-499 LOOP
HARLINGEN TX
78550
US

IV. Provider business mailing address

1201 TX-499 LOOP
HARLINGEN TX
78550
US

V. Phone/Fax

Practice location:
  • Phone: 956-427-3377
  • Fax: 956-427-3376
Mailing address:
  • Phone: 956-427-3377
  • Fax: 956-427-3376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number813734
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: