Provider Demographics
NPI:1467481549
Name:PAIK, ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:
Last Name:PAIK
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 1:7601 GLENVIEW DR.
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8331
Mailing Address - Country:US
Mailing Address - Phone:817-274-2578
Mailing Address - Fax:817-284-3921
Practice Address - Street 1:7601 GLENVIEW DR.
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8331
Practice Address - Country:US
Practice Address - Phone:817-274-2578
Practice Address - Fax:817-284-3921
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177807801Medicaid
TX177807801Medicaid