Provider Demographics
NPI:1669627410
Name:TODD ELSNER ENTERPIRSES, PLLC
Entity Type:Organization
Organization Name:TODD ELSNER ENTERPIRSES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ELSNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-657-5910
Mailing Address - Street 1:2510 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-1300
Mailing Address - Country:US
Mailing Address - Phone:817-930-0600
Mailing Address - Fax:817-451-1252
Practice Address - Street 1:2510 LITTLE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-1300
Practice Address - Country:US
Practice Address - Phone:817-930-0600
Practice Address - Fax:817-451-1252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10640302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization