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Individual

EUGENE T ELLISON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5402 SUMMERHILL RD, TEXARKANA, TX 75503-4607
(903) 614-3937
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
C4704
AR
207W00000X
Ophthalmology Physician
Primary
E9187
TX

Other

Enumeration date
07/28/2005
Last updated
07/14/2007
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