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Individual

ANTHONY ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
921 E FM 1187, CROWLEY, TX 76036-4363
(817) 297-2000
Mailing address
3226 RIDGE TRACE CIR, MANSFIELD, TX 76063-5364
(817) 308-3499

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42556
TX

Other

Enumeration date
04/09/2021
Last updated
04/09/2021
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