Elliott, Mark Ryan

Elliott, Mark Ryan is an individual health care provider with primary practice located at 2200 W Illinois Ave , Midland TX 79701-6407. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Elliott, Mark Ryan can be contacted via phone (432) 685-1111.

Contact Information

Primary practice address
2200 W Illinois Ave Midland TX 79701-6407
Phone: (432) 685-1111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA05006 Texas

Profile Details

NPI number 1174609424
LBN Legal business name Elliott, Mark Ryan
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2006
Last updated Jul 9th, 2012 - about 12 years ago

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 1174609424 NPPES
Texas MEDICAID 280874301
Texas Other P01030219

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