Individual
EPIFANIO ELIZONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1711 DOOLITTLE AVE, NAS JRB BRANCH CLINIC, FORT WORTH, TX 76127-1133
(817) 782-5923
(817) 782-5949
Mailing address
204 MEADOW CREEK LN, BURLESON, TX 76028-7960
(817) 447-7788
(214) 767-3209
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01753
TX
Other
Enumeration date
03/17/2008
Last updated
03/17/2008
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