Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 27101 | TX |
Y | 213EG0000X | General Practice | 27101 | TX |
NPI | 1003104845 |
---|---|
Provider Name | Dr. Elena Koshman Morrell |
First Address | Conroe, TX 77304-1826 |
Second Address | Conroe, TX 77304-1826 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2011 |
Last Update Date | 13/07/2017 |