Douglass, Elizabeth Tate
Douglass, Elizabeth Tate is an individual health care provider with primary practice located at 313 E 12Th St Ste 102 , Austin TX 78701-1955. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Douglass, Elizabeth Tate can be contacted via phone (409) 772-2222.Contact Information
Primary practice address
313 E 12Th St Ste 102
Austin TX 78701-1955
Phone: (409) 772-2222
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | J1975 | Texas |
Profile Details
| NPI number | 1073675401 |
|---|---|
| LBN Legal business name | Douglass, Elizabeth Tate |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 14th, 2006 |
| Last updated | Dec 14th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073675401 | NPPES |
| Texas | Other | 86317J | BCBS |
| Texas | MEDICAID | 129870508 | BCBS |
| Texas | MEDICAID | 129870506 | BCBS |
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