Individual
DR. MISTI G. ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6431 FANNIN ST, SUITE JJL 495, HOUSTON, TX 77030-1501
(713) 500-6645
(713) 500-5666
Mailing address
6431 FANNIN ST, SUITE JJL 495, HOUSTON, TX 77030-1501
(713) 500-6645
(713) 500-5666
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
N2486
TX
2080P0208X
Pediatric Infectious Diseases Physician
Primary
N2486
TX
Other
Enumeration date
01/15/2008
Last updated
04/29/2020
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