Individual
ELISSA LIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18707 HARDY OAK BLVD, SAN ANTONIO, TX 78258-4791
(210) 614-1234
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2200
(214) 231-2159
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
V0021
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75-2005254
TEXAS DIGESTIVE DISEASE CONSULTANTS
TX
Enumeration date
04/12/2018
Last updated
08/19/2024
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