Individual
CHERYL VANDERBILT-ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-0776
(214) 867-5398
Mailing address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-0776
(214) 867-5398
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085002695
IL
363AM0700X
Medical Physician Assistant
Primary
PA08693
TX
Other
Enumeration date
09/13/2007
Last updated
08/15/2016
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