Provider Demographics
NPI:1598398851
Name:ELIAS, REMY RENE
Entity Type:Individual
Prefix:
First Name:REMY
Middle Name:RENE
Last Name:ELIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3552 FM 1092 RD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2203
Mailing Address - Country:US
Mailing Address - Phone:346-368-4412
Mailing Address - Fax:
Practice Address - Street 1:3552 FM 1092 RD
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2203
Practice Address - Country:US
Practice Address - Phone:346-368-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-19-38975103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst