Ellis, Thomas S

Ellis, Thomas S is an individual health care provider with primary practice located at 1900 Mistletoe Blvd Ste 200 , Fort Worth TX 76104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Ellis, Thomas S can be contacted via phone (817) 878-5333.

Contact Information

Primary practice address
1900 Mistletoe Blvd Ste 200 Fort Worth TX 76104
Phone: (817) 878-5333
Fax: (817) 878-5334
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X H9911 Texas

Profile Details

NPI number 1629004445
LBN Legal business name Ellis, Thomas S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Jun 27th, 2018 - about 6 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 1629004445 NPPES
Texas MEDICAID 089947804
Texas Other 8H9671

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