Basic Information
Provider Information
NPI: 1801358122
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DURAN
FirstName: ELIZABETH
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6720 BERTNER AVE # O520
Address2:  
City: HOUSTON
State: TX
PostalCode: 770302604
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 6720 BERTNER AVE # O-520
Address2:  
City: HOUSTON
State: TX
PostalCode: 770302604
CountryCode: US
TelephoneNumber: 8323552666
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/04/2019
LastUpdateDate: 04/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XAP139997TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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