Provider Demographics
NPI:1477964526
Name:TOLLEMACHE, JULIE ELLIS (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ELLIS
Last Name:TOLLEMACHE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1345 PHILOMENA ST # 305
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3210
Mailing Address - Country:US
Mailing Address - Phone:512-324-2082
Mailing Address - Fax:
Practice Address - Street 1:1600 W 38TH ST STE 212
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6405
Practice Address - Country:US
Practice Address - Phone:512-324-3315
Practice Address - Fax:512-324-3314
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR09682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry