Organization
ELLA HOSPITALIST PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE VAN DE WATER (ACCOUNT MANAGER)
(602) 569-4740
Entity
Organization
Contact information
Practice address
2607 GALLION DR, SUGAR LAND, TX 77479-1967
(281) 221-1010
Mailing address
2607 GALLION DR, SUGAR LAND, TX 77479-1967
(281) 221-1010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
282N00000X
General Acute Care Hospital
Primary
N 3875
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811322126
—
TX
Enumeration date
09/05/2013
Last updated
04/22/2024
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