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Individual

DR. ANTHONY JOHN ELISCO III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4211 JOE RAMSEY BLVD E STE 100, GREENVILLE, TX 75401-7856
(903) 408-7930
(903) 408-7929
Mailing address
4215 JOE RAMSEY BLVD E, GREENVILLE, TX 75401-7852
(903) 408-5834
(903) 408-5693

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
OS007527L
PA
208800000X
Urology Physician
Primary
Q9805
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
366443501
TX
01
539307YMPG
MEDICARE
TX
Enumeration date
07/25/2006
Last updated
04/30/2026
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