Provider Demographics
NPI:1013067982
Name:ELKINS, TINA P (MD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:P
Last Name:ELKINS
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 1:1701 S PALESTINE ST STE A
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-5739
Mailing Address - Country:US
Mailing Address - Phone:903-675-3316
Mailing Address - Fax:903-675-1111
Practice Address - Street 1:1701 S PALESTINE ST STE A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-5739
Practice Address - Country:US
Practice Address - Phone:903-675-3316
Practice Address - Fax:903-675-1111
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18286207Y00000X
TXM0711207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173797501Medicaid
NV813419791OtherEMPLOYER TIN
TX8D5478Medicare ID - Type Unspecified