Healthcare Provider Details

I. General information

NPI: 1104867522
Provider Name (Legal Business Name): CELESTINE ALIPUI VAN LARE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CELESTINE ALIPUI M.D.

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3611 WALNUT FOREST LN
SPRING TX
77388-4503
US

IV. Provider business mailing address

3611 WALNUT FOREST LN
SPRING TX
77388-4503
US

V. Phone/Fax

Practice location:
  • Phone: 281-450-2040
  • Fax: 281-288-3781
Mailing address:
  • Phone: 281-450-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberK3061
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK3061
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: