Provider Demographics
NPI:1013347210
Name:DANG, ELISA (APRN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:ELISA
Middle Name:
Last Name:DANG
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 WIRT RD STE F8
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-1232
Mailing Address - Country:US
Mailing Address - Phone:713-467-4900
Mailing Address - Fax:713-467-6006
Practice Address - Street 1:2323 WIRT RD STE F8
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-1232
Practice Address - Country:US
Practice Address - Phone:713-467-4900
Practice Address - Fax:713-467-6006
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX675784363LP0200X
TXAP112506363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675784OtherTEXAS BOARD OF NURSING RN
TX5069OtherPRESCRIPTIVE AUTHORITY
TXAP112506OtherTEXAS BOARD OF NURSING APRN
TX20030431OtherPEDIATRIC NURSING CERTIFICATION BOARD