Provider Demographics
NPI:1942215728
Name:MABUTE, ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:MABUTE
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 1:9534 HUFFMEISTER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2855
Mailing Address - Country:US
Mailing Address - Phone:281-861-9146
Mailing Address - Fax:281-861-0357
Practice Address - Street 1:9534 HUFFMEISTER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2855
Practice Address - Country:US
Practice Address - Phone:281-861-9146
Practice Address - Fax:877-860-8137
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010608251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010608OtherTX DEPT OF AGING & DISABILITY
TX743110Medicare Oscar/Certification