Individual
MAYRA ELIZONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128
Mailing address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
944960
TX
363L00000X
Nurse Practitioner
Primary
AP1097801
TX
363LF0000X
Family Nurse Practitioner
AP1097801
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
944960
RN
TX
Enumeration date
09/26/2020
Last updated
02/23/2026
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