Individual
SWATI ELLENDULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4500 HILLCREST RD STE 115, FRISCO, TX 75035-5418
(469) 213-6400
(469) 213-6473
Mailing address
4500 HILLCREST RD STE 115, FRISCO, TX 75035-5418
(469) 213-6400
(469) 213-6473
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
N9542
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
318515YVRJ
MEDICARE PTAN
TX
01
—
318515ZH85
MEDICARE PTAN
TX
Enumeration date
06/14/2007
Last updated
06/16/2016
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