Ellenbecker, Beau James

Ellenbecker, Beau James is an individual health care provider with primary practice located at 610 E Byron Nelson Blvd Suite 101, Roanoke TX 76262-6541. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ellenbecker, Beau James can be contacted via phone (817) 912-8200.

Contact Information

Primary practice address
610 E Byron Nelson Blvd Suite 101 Roanoke TX 76262-6541
Phone: (817) 912-8200
Fax: (817) 912-8210
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X P1069 Texas

Profile Details

NPI number 1679774582
LBN Legal business name Ellenbecker, Beau James
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2007
Last updated Mar 16th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679774582 NPPES
Texas MEDICAID 307543401

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