person
Mr. Mark D. Ellis, NP
Family Nurse Practitioner in Johnson City, Texas
NPI 1508868530

Mark D. Ellis is a Family Nurse Practitioner based in Dallas, TX and is specialized in Family. Mark D. Ellis practices in Johnson City, TX and has the professional credentials of NP. The NPI Number for Mark D. Ellis is 1508868530 and holds a License No. 609633 (Texas).

The current practice location address for Mark D. Ellis is 208 Haley Rd, Johnson City, TX and can be reached out via phone at 830-868-9500 and via fax at 830-868-4606.

Location: 208 Haley Rd, Johnson City, TX, 75284-4658
person
Provider Profile Details
NPI Number
1508868530
Provider Name
Mark D. Ellis
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
208 Haley Rd, Johnson City, TX, 75284-4658
Phone Number
830-868-9500
Fax Number
830-868-4606
Provider Enumeration Date
08/10/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8N3533 01 TX BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
208 Haley Rd
City
State
Zip
78636-4617
Phone Number
830-868-9500
Fax Number
830-868-4606
person
Provider Business Mailing Address Details
Address
208 Haley Rd
City
State
Zip
78636-4617
Phone Number
830-868-9500
Fax Number
830-868-4606
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
609633 (Texas)
Definition
Definition to come...
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