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Individual

MS. RACHEL JOY ELLSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
18400 KATY FWY, SUITE 560, HOUSTON, TX 77094-1286
(832) 522-3240
(281) 578-2404
Mailing address
18400 KATY FWY, SUITE 560, HOUSTON, TX 77094-1286
(832) 522-3240
(281) 578-2404

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
N1878
TX
390200000X
Student in an Organized Health Care Education/Training Program
TMB PIT#
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
342229701
TX
05
342229702
TX
01
8EQ602
BCBS
TX
01
8GD754
BCBS
TX
Enumeration date
11/14/2008
Last updated
02/04/2022
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