Healthcare Provider Details
I. General information
NPI: 1871733121
Provider Name (Legal Business Name): ELISE MICHELE BARRETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/26/2009
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16001 PARK TEN PL STE 300
HOUSTON TX
77084-7885
US
IV. Provider business mailing address
9450 SW GEMINI DR PMB49084
BEAVERTON OR
97008
US
V. Phone/Fax
- Phone: 713-407-3000
- Fax: 713-461-5307
- Phone: 713-407-3000
- Fax: 713-461-5307
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 39002779A |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083B0002X |
| Taxonomy | Obesity Medicine (Preventive Medicine) Physician |
| License Number | P2163 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | P2163 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: