# ERIC ELLIS DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659590214
- **Authorized official:** DR. ERIC JOSEPH ELLIS DDS (PRESIDENT)
- **Authorized official phone:** (281) 991-1361

## Contact information

- **Practice address:** 4600 FAIRMONT PKWY, SUITE 204, PASADENA, TX 77504-3335
- **Practice address phone:** (281) 991-1361
- **Practice address fax:** (281) 991-9190
- **Mailing address:** 4600 FAIRMONT PKWY, SUITE 204, PASADENA, TX 77504-3335
- **Mailing address phone:** (281) 991-1361
- **Mailing address fax:** (281) 991-9190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 18175 | TX | Yes |

## Other

- **Enumeration date:** 04/24/2007
- **Last updated:** 08/22/2020