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NPI Code Detail

MEDICARE: MRS. ELIZABETH MARIE MARTINEZ-ALAMILLO PA-C

MEDICARE: MRS. ELIZABETH MARIE MARTINEZ-ALAMILLO PA-C
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
1363AM0700XMedical Physician AssistantPA03280TX

General Provider Information

NPI Number : 1912205832
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH MARIE MARTINEZ-ALAMILLO PA-C
Provider Business Mailing Address
First Line : 2525 N VETERANS BLVD
Second Line : PO BOX 1470
City : EAGLE PASS
State : TX
Zip : 78852-3302
Country : US
Telephone Number : 830-757-6946
Fax Number : 830-757-5850
Provider Business Practice Location Address
First Line : 1175 EIDSON RD
Second Line :
City : EAGLE PASS
State : TX
Zip : 78852-5403
Country : US
Telephone Number : 830-757-6946
Fax Number : 830-757-5850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2011
Last Update Date : 03/01/2011

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