Provider Demographics
NPI:1033359823
Name:BOSQUEZ, ELIZABETH LEE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LEE
Last Name:BOSQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12340 JONES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4863
Mailing Address - Country:US
Mailing Address - Phone:713-873-5241
Mailing Address - Fax:713-873-5266
Practice Address - Street 1:12340 JONES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4863
Practice Address - Country:US
Practice Address - Phone:713-873-5241
Practice Address - Fax:713-873-5266
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN2412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics