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Organization

SOUTHWEST REGIONAL ORTHOPEDIC SPORTS MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES SCOTT ELLIS DO (OWNER PROVIDER)
(214) 333-9175
Entity
Organization

Contact information

Practice address
1505 W JEFFERSON, SUITE 102, WAXAHACHIE, TX 75165
(972) 923-3800
(972) 351-9360
Mailing address
PO BOX 381329, DUNCANVILLE, TX 75165
(972) 923-3800
(972) 351-9360

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1757635201
TX
05
1757635203
TX
Enumeration date
01/12/2007
Last updated
08/28/2008
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