Provider Demographics
NPI:1013476498
Name:THOYAKULATHU, ELIZABETH MIRIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MIRIAM
Last Name:THOYAKULATHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 OLD SPANISH TRL APT 127
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1955
Mailing Address - Country:US
Mailing Address - Phone:214-274-5341
Mailing Address - Fax:
Practice Address - Street 1:1711 OLD SPANISH TRL APT 127
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1955
Practice Address - Country:US
Practice Address - Phone:214-274-5341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU0862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine