Individual
MS. ELCY MATHAI JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
455 SCHOOL ST, SUITE 29, TOMBALL, TX 77375-4595
(281) 374-1860
(281) 255-0550
Mailing address
455 SCHOOL ST, SUITE 29, TOMBALL, TX 77375-4595
(281) 374-1860
(281) 255-0550
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
L8126
TX
207V00000X
Obstetrics & Gynecology Physician
24991
OK
207V00000X
Obstetrics & Gynecology Physician
34806
OK
207V00000X
Obstetrics & Gynecology Physician
Primary
L8126
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171664901
—
TX
05
—
200099770A
—
TX
01
—
8R1193
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/28/2005
Last updated
12/27/2012
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