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General NPI Number Information
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NPI Number | 1073707394
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Entity Type | Organization
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Legal Business Name | E. LEON ETTER II MD PA
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 1315 ST JOSEPH PKWY SUITE 1708
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City | HOUSTON
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State | TX
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Zip | 77002-8233
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Country | US
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Telephone | 713-739-1391
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Fax | 713-759-0786
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Provider Business Mailing Address
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Address Line | 1315 ST JOSEPH PKWY SUITE 1708
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City | HOUSTON
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State | TX
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Zip | 77002-8233
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Country | US
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Telephone | 713-739-1391
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Fax | 713-759-0786
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELEGY LEON ETTER II
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Credential | MD
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Telephone | 713-739-1391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G3336
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License Number State | TX
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