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NPI Code Detail

MEDICARE: ELIZABETH ANDREA CISNEROS

MEDICARE: ELIZABETH ANDREA CISNEROS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant

General Provider Information

NPI Number : 1356042840
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANDREA CISNEROS
Provider Business Mailing Address
First Line : 2121 MIDWAY RD STE 145
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-5263
Country : US
Telephone Number : 972-851-1022
Fax Number :
Provider Business Practice Location Address
First Line : 2121 MIDWAY RD STE 145
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-5263
Country : US
Telephone Number : 972-851-1022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2023
Last Update Date : 03/13/2023

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Directions to “ ELIZABETH ANDREA CISNEROS ” Practice Location

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