Individual
EKATARINA GOUKASOVA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030
(888) 488-3627
Mailing address
1612 LAMONTE LN, HOUSTON, TX 77018-4102
(772) 332-7217
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101020478
MI
208600000X
Surgery Physician
R5256
TX
Other
Enumeration date
05/31/2013
Last updated
08/21/2018
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