Provider Demographics
NPI:1225066228
Name:ELEY, CHERYL D (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:D
Last Name:ELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6587 VIRGINIA PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5511
Mailing Address - Country:US
Mailing Address - Phone:972-548-8382
Mailing Address - Fax:972-547-9951
Practice Address - Street 1:6587 VIRGINIA PARKWAY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5511
Practice Address - Country:US
Practice Address - Phone:972-548-8382
Practice Address - Fax:972-547-9951
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2012208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043077902Medicaid
TX043077902Medicaid
TX8B6677Medicare PIN