Healthcare Provider Details

I. General information

NPI: 1104385889
Provider Name (Legal Business Name): ELIANA CRUZ MARTINEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 S F ST STE A
HARLINGEN TX
78550-6783
US

IV. Provider business mailing address

2906 ELLIE CIR
HARLINGEN TX
78552-0023
US

V. Phone/Fax

Practice location:
  • Phone: 956-444-0844
  • Fax: 956-444-0845
Mailing address:
  • Phone: 956-454-7379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP132703
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: