Organization
ELLIS G MAIN DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIS GERARD MAIN D.O. (OWNER)
(361) 387-9233
Entity
Organization
Contact information
Practice address
3022 MCKINZIE RD, CORPUS CHRISTI, TX 78410-2628
(361) 241-6700
Mailing address
PO BOX 10426, CORPUS CHRISTI, TX 78460-0426
(361) 387-9233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J2176
TX
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149471801
—
TX
Enumeration date
09/12/2007
Last updated
10/16/2025
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