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General NPI Number Information
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NPI Number | 1568132926
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Entity Type | Individual
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Provider Name | MA ELENA COURRECH MARTIN DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 101 E EXPRESSWAY 83 STE 120
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City | MCALLEN
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State | TX
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Zip | 78501-1164
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Country | US
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Telephone | 956-215-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 1902 S VILLA REAL DR
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City | PHARR
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State | TX
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Zip | 78577-6749
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Country | US
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Telephone | 727-204-2842
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 37887
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License Number State | TX
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