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1669177465
ISTMENIA ELLIS
STAFFORD, TX
NPI
1669177465
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 1096900)
Enumeration Date
2023-04-03
Last Update Date
2023-04-03
Business Address
ISTMENIA ELLIS
12310 MEADOW RIDGE DR
STAFFORD, TX 77477-2249
Phone number: 832-483-4781
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Mailing Address
ISTMENIA ELLIS
12310 MEADOW RIDGE DR
STAFFORD, TX 77477-2249
Phone number: 832-483-4781
Copy
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