Provider Demographics
NPI:1760278352
Name:DOUGLAS, MARIA (CPT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:DOUGLAS
Suffix:
Gender:
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13689 OLNEY AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-2276
Mailing Address - Country:US
Mailing Address - Phone:828-660-9255
Mailing Address - Fax:
Practice Address - Street 1:13689 OLNEY AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79928-2276
Practice Address - Country:US
Practice Address - Phone:828-660-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty