Organization
ELIS MEDICAL CORPORATION
Active
Organization
ELIS MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY SCHRIMPF (COO)
(817) 355-8000
Entity
Organization
Contact information
Practice address
5207 HERITAGE AVE, COLLEYVILLE, TX 76034-5915
(817) 355-8000
(817) 553-3536
Mailing address
5207 HERITAGE AVE, COLLEYVILLE, TX 76034-5915
(817) 355-8000
(817) 553-3536
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011CK
BCBS
TX
05
—
079735901
—
TX
01
—
2517940
AETNA
TX
01
—
6401723
CIGNA
TX
01
—
7300217
AETNA
TX
Enumeration date
02/23/2007
Last updated
05/09/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up