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General NPI Number Information
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NPI Number | 1518745066
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Entity Type | Individual
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Provider Name | MARIA GUADALUPE NAVARRO ELIAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 21 ALPINE ST
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City | COLDSPRING
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State | TX
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Zip | 77331-8058
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Country | US
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Telephone | 936-647-2227
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Fax |
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Provider Business Mailing Address
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Address Line | 406 INDUSTRIAL PARK LN
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City | WILLIS
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State | TX
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Zip | 77378-3039
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Country | US
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Telephone | 936-520-2969
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17084
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License Number State | TX
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