Provider Demographics
NPI:1942511878
Name:ELITE ORTHOPEDICS SPORTS MEDICINE
Entity Type:Organization
Organization Name:ELITE ORTHOPEDICS SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:TORRES
Authorized Official - Last Name:BARRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-997-3717
Mailing Address - Street 1:8603 BROADWAY ST
Mailing Address - Street 2:SUITE #101
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8171
Mailing Address - Country:US
Mailing Address - Phone:281-997-3717
Mailing Address - Fax:281-997-3817
Practice Address - Street 1:8603 BROADWAY ST
Practice Address - Street 2:SUITE #101
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8171
Practice Address - Country:US
Practice Address - Phone:281-997-3717
Practice Address - Fax:281-997-3817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX981363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty