Provider Demographics
NPI:1184643769
Name:KING, ELIZABETH ANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANDRA
Last Name:KING
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1355 CENTRAL PKWY S
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5055
Mailing Address - Country:US
Mailing Address - Phone:210-495-1900
Mailing Address - Fax:210-650-5975
Practice Address - Street 1:502 MADISON OAK DR
Practice Address - Street 2:SUITE 240
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4084
Practice Address - Country:US
Practice Address - Phone:210-495-1900
Practice Address - Fax:210-650-5975
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2015-06-04
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Provider Licenses
StateLicense IDTaxonomies
TXM1187207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176415101Medicaid
TX176415102Medicaid
TX176415101Medicaid
TX8F21864Medicare PIN