Ellis, Lisa Gunter

Ellis, Lisa Gunter is an individual health care provider with primary practice located at 4101 S Medford Dr , Lufkin TX 75901-5633. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Ellis, Lisa Gunter can be contacted via phone (936) 639-1141.

Contact Information

Primary practice address
4101 S Medford Dr Lufkin TX 75901-5633
Phone: (936) 639-1141
Fax: (936) 633-5695
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 1165899 Texas

Profile Details

NPI number 1275604332
LBN Legal business name Ellis, Lisa Gunter
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 12th, 2006
Last updated Jul 9th, 2007 - about 18 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 1275604332 NPPES
Texas Other 8T6242 BLUE CROSS BLUE SHIELD

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