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Individual
DR. TSION ELAINE HAILESELASSIE
Active
Individual
DR. TSION ELAINE HAILESELASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L5755
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062MB
BLUE CROSS BLUE SHIELD
TX
05
—
156051802
—
TX
05
—
2000788830A
—
OK
01
—
L5755
LICENSE NUMBER
TX
01
—
XD127252
DPS NUMBER
TX
Enumeration date
04/19/2007
Last updated
03/07/2023
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