Individual
KENT T ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 W 38TH ST, SUITE 308, AUSTIN, TX 78731-6400
(512) 324-3540
(512) 324-3541
Mailing address
1400 N IH 35, SUITE 300, AUSTIN, TX 78701-1926
(512) 324-8300
(512) 324-8301
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
J3304
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102573604
—
TX
05
—
160104904
—
TX
Enumeration date
09/20/2006
Last updated
01/29/2013
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