Provider Demographics
NPI:1083798441
Name:MOONEY, ELIZABETH
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:MOONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:MOONEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6599 KINGS CROWN E
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4719
Mailing Address - Country:US
Mailing Address - Phone:210-946-2769
Mailing Address - Fax:210-946-2769
Practice Address - Street 1:6599 KINGS CROWN E
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4719
Practice Address - Country:US
Practice Address - Phone:210-946-2769
Practice Address - Fax:210-946-2769
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2010-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK73492085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging