Provider Demographics
NPI:1780989756
Name:GEORGE E ELHAJ MD P A
Entity type:Organization
Organization Name:GEORGE E ELHAJ MD P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:EID
Authorized Official - Last Name:ELHAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-440-7878
Mailing Address - Street 1:810 PEAKWOOD DR
Mailing Address - Street 2:STE 202
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2921
Mailing Address - Country:US
Mailing Address - Phone:281-440-7878
Mailing Address - Fax:281-440-9316
Practice Address - Street 1:810 PEAKWOOD DR
Practice Address - Street 2:STE 202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2921
Practice Address - Country:US
Practice Address - Phone:281-440-7878
Practice Address - Fax:281-440-9316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0990207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0342206-01Medicaid
B22505Medicare UPIN
TX00JM37Medicare PIN