Provider Demographics
NPI:1386694206
Name:PELTIER, ELAINE C (M D)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:C
Last Name:PELTIER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 FANNIN ST
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2934
Mailing Address - Country:US
Mailing Address - Phone:713-790-1349
Mailing Address - Fax:
Practice Address - Street 1:7900 FANNIN ST
Practice Address - Street 2:SUITE 2300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2934
Practice Address - Country:US
Practice Address - Phone:713-790-1349
Practice Address - Fax:713-790-0028
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0860207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1255960-06Medicaid
TX125596005Medicaid
TX8S6752OtherBLUE CROSS & BLUE SHIELD
TX1255960-06Medicaid
TX8S6752OtherBLUE CROSS & BLUE SHIELD
TX125596005Medicaid