Basic Information
| Provider Information | |||||||||
| NPI: | 1649566837 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LARISSA A SZEYKO, M D PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 MINA PERDIDA ST | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799022204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9153516600 | ||||||||
| FaxNumber: | 5203516601 | ||||||||
| Practice Location | |||||||||
| Address1: | 2101 N OREGON ST | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799023346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155777840 | ||||||||
| FaxNumber: | 9155777822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2011 | ||||||||
| LastUpdateDate: | 06/26/2011 | ||||||||
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| AuthorizedOfficialLastName: | SZEYKO | ||||||||
| AuthorizedOfficialFirstName: | LARISSA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5202506184 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | M7675 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.