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Individual
KATHERINE L ELLIS
Active
Individual
KATHERINE L ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J3091
TX
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J3091
TX
225400000X
Rehabilitation Practitioner
J3091
TX
Other
Enumeration date
12/28/2005
Last updated
01/03/2012
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