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General NPI Number Information
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NPI Number | 1003806340
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Entity Type | Individual
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Provider Name | ELIZABETH ANN NEWKIRK P.A.
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Gender | Female
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 08/22/2017
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Provider Practice Location Address
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Address Line | 5656 KELLEY ST ROOM IEC 93006
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City | HOUSTON
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State | TX
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Zip | 77026-1967
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Country | US
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Telephone | 713-566-5397
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Fax | 713-566-4711
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Provider Business Mailing Address
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Address Line | 500 WEST MEDICAL CENTER BLVD
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City | WEWBSTER
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State | TX
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Zip | 77598-4220
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Country | US
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Telephone | 713-864-2733
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA03102
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License Number State | TX
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