Provider Demographics
NPI:1679575146
Name:MULLANS, ELIZABETH A (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:MULLANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2211 NORFOLK STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4030
Mailing Address - Country:US
Mailing Address - Phone:713-623-2336
Mailing Address - Fax:713-623-4441
Practice Address - Street 1:2211 NORFOLK STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4030
Practice Address - Country:US
Practice Address - Phone:713-623-2336
Practice Address - Fax:713-623-4441
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-13
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7284207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
8H8970OtherBLUE CROSS BLUE SHIELD
8H8970OtherBLUE CROSS BLUE SHIELD
8A5936Medicare ID - Type Unspecified