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Individual

ELLIS L MINTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
709 W LEUDA ST, FORT WORTH, TX 76104-3115
(817) 926-2511
(817) 924-0167
Mailing address
709 W LEUDA ST, FORT WORTH, TX 76104-3115
(817) 926-2511
(817) 924-0167

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D3064
TX

Other

Enumeration date
07/18/2006
Last updated
01/10/2014
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