Provider Demographics
NPI:1871733121
Name:BARRETT, ELISE MICHELE (MD)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:MICHELE
Last Name:BARRETT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:YASMEEN
Other - Last Name:SADOUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9450 SW GEMINI DR
Mailing Address - Street 2:PMB49084
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008
Mailing Address - Country:US
Mailing Address - Phone:713-407-3000
Mailing Address - Fax:713-461-5307
Practice Address - Street 1:16001 PARK TEN PL STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7885
Practice Address - Country:US
Practice Address - Phone:713-407-3000
Practice Address - Fax:713-461-5307
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH39002779A207Q00000X
TXP21632083B0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
328136YXA7Medicare PIN