Healthcare Provider Details

I. General information

NPI: 1598468712
Provider Name (Legal Business Name): ELISA MEREDITH WILLIAMS KUNKEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6707 STERLING RIDGE DR STE A
SPRING TX
77382-2773
US

IV. Provider business mailing address

6707 STERLING RIDGE DR STE A
SPRING TX
77382-2773
US

V. Phone/Fax

Practice location:
  • Phone: 281-296-2656
  • Fax: 281-367-1286
Mailing address:
  • Phone: 281-296-2656
  • Fax: 281-367-1286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW5851
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: