Provider Demographics
NPI:1952542680
Name:ELIAS, GEORG (MD)
Entity Type:Individual
Prefix:
First Name:GEORG
Middle Name:
Last Name:ELIAS
Suffix:
Gender:M
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:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-0087
Mailing Address - Country:US
Mailing Address - Phone:281-501-5652
Mailing Address - Fax:800-718-5287
Practice Address - Street 1:24044 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1500
Practice Address - Country:US
Practice Address - Phone:281-501-5652
Practice Address - Fax:800-718-5287
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP01192207R00000X
IL036132738207RG0100X
TXQ8052207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214881Medicare Oscar/Certification