Provider Demographics
NPI:1245777440
Name:DAVID P ELLENT PLLC
Entity type:Organization
Organization Name:DAVID P ELLENT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:ELLENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-975-1000
Mailing Address - Street 1:2255 E MOSSY OAKS RD STE 500
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-1813
Mailing Address - Country:US
Mailing Address - Phone:281-975-1000
Mailing Address - Fax:281-975-1001
Practice Address - Street 1:2255 E MOSSY OAKS RD STE 500
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-1813
Practice Address - Country:US
Practice Address - Phone:281-975-1000
Practice Address - Fax:281-975-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7366207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX553278Medicare PIN