Ellis, Robert S

Ellis, Robert S is an individual health care provider with primary practice located at 910 E Houston St Ste 530, Tyler TX 75702-8369. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Ellis, Robert S can be contacted via phone (903) 531-5560.

Contact Information

Primary practice address
910 E Houston St Ste 530 Tyler TX 75702-8369
Phone: (903) 531-5560
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X M1656 Texas
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X M1656 Texas

Profile Details

NPI number 1093864027
LBN Legal business name Ellis, Robert S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Mar 8th, 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 1093864027 NPPES
Texas Other TIN PLUS 096 TRICARE
Texas MEDICAID 178944801 TRICARE
Texas Other 86515S TRICARE
Texas Other 8BC264 TRICARE

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