Provider Demographics
NPI:1649320771
Name:ARIAS, ELLEN MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:MARIE
Last Name:ARIAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:ELLEN
Other - Middle Name:MARIE
Other - Last Name:ARIAS RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20131 HIGHWAY 59 N
Mailing Address - Street 2:1238
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-2305
Mailing Address - Country:US
Mailing Address - Phone:281-446-4237
Mailing Address - Fax:281-446-6942
Practice Address - Street 1:20131 HIGHWAY 59 N
Practice Address - Street 2:1238
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-2305
Practice Address - Country:US
Practice Address - Phone:281-446-4237
Practice Address - Fax:281-446-6942
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX180031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice