Individual
ELLISIV LIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2737 S BROADWAY AVE, TYLER, TX 75701-5413
(903) 592-6000
(903) 592-3224
Mailing address
PO BOX 6605, TYLER, TX 75711-6605
(903) 592-6000
(903) 592-3224
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
N1735
TX
Other
Enumeration date
01/22/2009
Last updated
01/31/2019
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