Provider Demographics
NPI:1174512552
Name:BAZE, ELIZABETH F (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:F
Last Name:BAZE
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:PO BOX 4771
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4771
Mailing Address - Country:US
Mailing Address - Phone:713-798-6100
Mailing Address - Fax:713-798-4231
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1501
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-798-6100
Practice Address - Fax:713-798-4231
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6284207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159783301Medicaid
TX159783303Medicaid
TX159783304Medicaid
TX8J3910OtherBC/BS
TX00810890OtherBLUE LINK
TX159783304Medicaid
TXP00175606Medicare PIN
TX00810890OtherBLUE LINK
H91247Medicare UPIN