Provider Demographics
NPI:1942693452
Name:HOBAUGH, ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HOBAUGH
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 1:7300 BROMPTON ST
Mailing Address - Street 2:APT 5835
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2180
Mailing Address - Country:US
Mailing Address - Phone:903-824-1194
Mailing Address - Fax:
Practice Address - Street 1:5757 WOODWAY DR
Practice Address - Street 2:SUITE 202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1514
Practice Address - Country:US
Practice Address - Phone:903-824-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-08
Last Update Date:2015-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116717225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics