Organization
WOMENS ENVIRONMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAISHREE RIVA ELLIS MD (PRESIDENT)
(903) 343-1265
Entity
Organization
Contact information
Practice address
619 COURTVIEW, TYLER, TX 75703-5916
(903) 343-1265
(903) 561-6176
Mailing address
619 COURTVIEW, TYLER, TX 75703-5916
(903) 343-1265
(903) 561-6176
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M9998
TX
Other
Enumeration date
11/28/2009
Last updated
11/28/2009
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