Provider Demographics
NPI:1659258788
Name:ELIZONDO, WILLIAM ERIK
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ERIK
Last Name:ELIZONDO
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 GULF FWY S
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6750
Mailing Address - Country:US
Mailing Address - Phone:281-337-5210
Mailing Address - Fax:
Practice Address - Street 1:2955 GULF FWY S
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6750
Practice Address - Country:US
Practice Address - Phone:281-337-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76113183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist