Ellis, Emily

Ellis, Emily is an individual health care provider with primary practice located at 5430 Fredericksburg Rd , San Antonio TX 78229-3539. She recently has 3 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Pediatric, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Ellis, Emily can be contacted via phone (210) 297-4000.

Contact Information

Primary practice address
5430 Fredericksburg Rd San Antonio TX 78229-3539
Phone: (210) 297-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Pediatric 133VN1004X ND6061 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA14548 Texas
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9112117 Florida

Profile Details

NPI number 1487056842
LBN Legal business name Ellis, Emily
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2014
Last updated Dec 2nd, 2022 - about 2 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 1487056842 NPPES
Florida MEDICAID 105187500
Florida Other 5ILU8

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