Individual
IDALY MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2106 N ZARAGOZA RD STE A110, EL PASO, TX 79938-8097
(915) 274-4125
Mailing address
1329 MICHELANGELO DR, EL PASO, TX 79936-7245
(915) 316-3256
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT112260
TX
Other
Enumeration date
10/23/2024
Last updated
08/06/2026
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