Provider Demographics
NPI:1194035618
Name:JAMES E ELBAOR MD PA
Entity Type:Organization
Organization Name:JAMES E ELBAOR MD PA
Other - Org Name:AMERICAN INSTITUTE OF ORTHOPAEDIC SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:ELBAOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:817-467-7113
Mailing Address - Street 1:3225 OMEGA DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2006
Mailing Address - Country:US
Mailing Address - Phone:817-467-7113
Mailing Address - Fax:817-467-7877
Practice Address - Street 1:3225 OMEGA DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2006
Practice Address - Country:US
Practice Address - Phone:817-467-7113
Practice Address - Fax:817-467-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7062207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty