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General NPI Number Information
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NPI Number | 1093857070
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Entity Type | Individual
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Provider Name | ELIE R EL-HAGE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 13948 LONE RIDER TRL
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City | BEE CAVE
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State | TX
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Zip | 78738-6431
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Country | US
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Telephone | 512-294-0005
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Fax | 512-402-1473
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Provider Business Mailing Address
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Address Line | 13948 LONE RIDER TRL
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City | AUSTIN
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State | TX
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Zip | 78738-6431
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Country | US
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Telephone | 512-294-0005
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 16826
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License Number State | TX
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