Individual
MRS. MELANIE JANE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
359 MEDICAL GROUP, 221 THRID STREET WEST, BLDG 1040, JBSA-RANDOLPH, TX 78150
(210) 652-8544
Mailing address
145 CLAPBOARD RUN, CIBOLO, TX 78108-4334
(210) 563-9646
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003433
WA
Other
Enumeration date
10/27/2006
Last updated
05/01/2018
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