Basic Information
Provider Information
NPI: 1285010132
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELKINS
FirstName: MARIA
MiddleName: NATHALIA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14275 MIDWAY RD STE 400
Address2:  
City: ADDISON
State: TX
PostalCode: 750013676
CountryCode: US
TelephoneNumber: 4058422061
FaxNumber: 6102714245
Practice Location
Address1: 225 NE 97TH ST STE 600
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731146302
CountryCode: US
TelephoneNumber: 4058422061
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/03/2015
LastUpdateDate: 05/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X31496OKY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


Home