Individual
ELLE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 MEDICAL PLAZA CT, GRANBURY, TX 76048-5653
(817) 573-5688
(817) 415-0722
Mailing address
47 HILL ST, LOGAN, OH 43138-1509
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
12324567890
WV
363A00000X
Physician Assistant
Primary
PA18330
TX
Other
Enumeration date
12/06/2023
Last updated
10/17/2025
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