Provider Demographics
NPI:1104867522
Name:ALIPUI VAN LARE, CELESTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CELESTINE
Middle Name:
Last Name:ALIPUI VAN LARE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CELESTINE
Other - Middle Name:
Other - Last Name:ALIPUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 BAYLOR PLZ # BCM621
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-8188
Mailing Address - Fax:
Practice Address - Street 1:17200 ST LUKES WAY
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8007
Practice Address - Country:US
Practice Address - Phone:281-587-5087
Practice Address - Fax:713-798-8188
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3061208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0097LPOtherBLUE CROSS BLUE SHIELD
TX047276304Medicaid
F92069Medicare UPIN
TX047276304Medicaid