Individual
RICHARD ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7979 WURZBACH RD, SAN ANTONIO, TX 78229-4427
(210) 450-1000
(210) 450-1000
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 450-9000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
F9395
TX
207RX0202X
Medical Oncology Physician
Primary
F9395
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124698505
—
TX
Enumeration date
10/17/2006
Last updated
10/01/2018
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