Provider Demographics
NPI:1205195179
Name:RODRIGUEZ LIEN, ELIZABETH ANN (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:RODRIGUEZ LIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:UTMB CHILDREN'S HOSPITAL 3 230
Mailing Address - Street 2:301 UNIVERSITY BLVD
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0354
Mailing Address - Country:US
Mailing Address - Phone:409-747-0534
Mailing Address - Fax:409-747-0721
Practice Address - Street 1:UTMB CHILDRENS HOSPITAL 3 230
Practice Address - Street 2:301 UNIVERSITY BLVD
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0354
Practice Address - Country:US
Practice Address - Phone:409-747-0534
Practice Address - Fax:409-747-0721
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4265208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics