Individual
KATHERINE L ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 REBA MCENTIRE DR, DENISON, TX 75020-9057
(903) 416-1025
(903) 327-8023
Mailing address
1302 N STATE HIGHWAY 91, DENISON, TX 75020-1167
(903) 465-1857
(903) 327-8023
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
J3091
TX
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J3091
TX
225400000X
Rehabilitation Practitioner
J3091
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099349501
—
TX
Enumeration date
12/28/2005
Last updated
01/03/2012
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