Provider Demographics
NPI:1376526285
Name:LALIBERTE, JOSEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEE
Middle Name:
Last Name:LALIBERTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 BLUME AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034
Mailing Address - Country:US
Mailing Address - Phone:281-772-8893
Mailing Address - Fax:713-910-5969
Practice Address - Street 1:11200 BLUME AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034
Practice Address - Country:US
Practice Address - Phone:281-772-8893
Practice Address - Fax:713-910-5969
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8581M0Medicare ID - Type Unspecified
G26931Medicare UPIN