Robertson, Ellis
Robertson, Ellis is an individual health care provider with primary practice located at 12700 Park Central Dr Ste 430, Dallas TX 75251-1527. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Robertson, Ellis can be contacted via phone (972) 239-8902.Contact Information
Primary practice address
12700 Park Central Dr Ste 430
Dallas TX 75251-1527
Phone: (972) 239-8902
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | J7162 | Texas |
Profile Details
| NPI number | 1568465920 |
|---|---|
| LBN Legal business name | Robertson, Ellis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2005 |
| Last updated | Feb 4th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568465920 | NPPES |
| Texas | MEDICAID | 128943103 |
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