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General NPI Number Information
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NPI Number | 1104820802
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Entity Type | Individual
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Provider Name | HELENA HELGA LIPTAKOVA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 9870 GATEWAY BLVD N STE B7
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City | EL PASO
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State | TX
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Zip | 79924-4425
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Country | US
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Telephone | 915-751-5245
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Fax | 915-751-5255
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Provider Business Mailing Address
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Address Line | PO BOX 593
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City | WHITE SULPHUR SPRINGS
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State | WV
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Zip | 24986-0593
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Country | US
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Telephone | 304-536-5030
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Fax | 304-536-5031
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K0894
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License Number State | TX
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