Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 87939 | TX |
NPI | 1144774589 |
---|---|
Provider Name | Mayra Zarrabal |
First Address | El Paso, TX 79938-1013 |
Second Address | El Paso, TX 79920-5002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2016 |
Last Update Date | 14/08/2016 |