Ellison, Corbet Kevin

Ellison, Corbet Kevin is an individual health care provider with primary practice located at 11233 Shadow Creek Pkwy Ste 120 , Pearland TX 77584-7345. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Ellison, Corbet Kevin can be contacted via phone (281) 741-5247.

Contact Information

Primary practice address
11233 Shadow Creek Pkwy Ste 120 Pearland TX 77584-7345
Phone: (281) 741-5247
Fax: (281) 741-5354
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DEN1000288 District of Columbia
Dental Providers / Pediatric Dentistry 1223P0221X 23589 Texas

Profile Details

NPI number 1699730895
LBN Legal business name Ellison, Corbet Kevin
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Oct 10th, 2011 - about 13 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 1699730895 NPPES
Texas MEDICAID 188083306

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