Individual
ELLEN ELMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11149 RESEARCH BLVD, SUITE 210, AUSTIN, TX 78759-5279
(512) 231-1901
(512) 231-1902
Mailing address
11149 RESEARCH BLVD, SUITE 210, AUSTIN, TX 78759-5279
(512) 231-1901
(512) 231-1902
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6418
AK
207Q00000X
Family Medicine Physician
8800
HI
207Q00000X
Family Medicine Physician
Primary
P2852
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313465201
—
TX
05
—
313465202
—
TX
Enumeration date
03/25/2008
Last updated
05/03/2013
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