Individual
RENEE ANN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1902 WINDSOR PL STE 102, FORT WORTH, TX 76110-1866
(682) 207-1700
(682) 250-5246
Mailing address
1902 WINDSOR PL STE 102, FORT WORTH, TX 76110-1866
(682) 207-1700
(682) 250-5246
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
31193
SC
207RN0300X
Nephrology Physician
Primary
W0564
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48355
—
SC
Enumeration date
03/24/2008
Last updated
01/09/2026
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