Provider Demographics
NPI:1477939395
Name:MORROW, ELLIS AVERY (RD)
Entity Type:Individual
Prefix:MR
First Name:ELLIS
Middle Name:AVERY
Last Name:MORROW
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 263607
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77207-3607
Mailing Address - Country:US
Mailing Address - Phone:281-734-2577
Mailing Address - Fax:
Practice Address - Street 1:11134 SHELDON BEND DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7290
Practice Address - Country:US
Practice Address - Phone:281-734-2577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDTO5637133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal