Organization
ELECTROCARDIOGRAPHY ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIM ELLINGTON M.D. (SEC. TREA.)
(903) 454-8133
Entity
Organization
Contact information
Practice address
4803 WESLEY ST, GREENVILLE, TX 75401-5649
(903) 454-8133
Mailing address
PO BOX 9234, GREENVILLE, TX 75404-9234
(903) 454-8133
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0828600-01
—
TX
01
—
CS3178
RAILROAD MEDICARE
TX
Enumeration date
04/13/2007
Last updated
06/27/2012
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