Provider Demographics
NPI:1962687905
Name:POGOSIAN, ELENA G (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:G
Last Name:POGOSIAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 734812
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-4812
Mailing Address - Country:US
Mailing Address - Phone:210-358-9500
Mailing Address - Fax:210-358-9183
Practice Address - Street 1:5282 MEDICAL DR STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6039
Practice Address - Country:US
Practice Address - Phone:210-358-8820
Practice Address - Fax:210-358-9434
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2021-05-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP1680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB148739OtherMEDICARE#