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General NPI Number Information
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NPI Number | 1811902307
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Entity Type | Individual
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Provider Name | ELIAS N EZIKE MD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 87 INTERSTATE 10 N STE 221
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City | BEAUMONT
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State | TX
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Zip | 77707-2562
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Country | US
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Telephone | 409-838-9944
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Fax | 409-838-9086
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Provider Business Mailing Address
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Address Line | 87 INTERSTATE 10 N STE 221
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City | BEAUMONT
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State | TX
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Zip | 77707-2562
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Country | US
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Telephone | 409-838-9944
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Fax | 409-838-9086
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 052430
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | M4774
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301076996
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | M4774
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License Number State | TX
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