Provider Demographics
NPI:1750875068
Name:ELLIS, ORIANA V (MD)
Entity type:Individual
Prefix:DR
First Name:ORIANA
Middle Name:V
Last Name:ELLIS
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 1:18511 HIGHLANDER MEDICS ST, WBAMC
Mailing Address - Street 2:MCHM-DOS-GSR
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79906
Mailing Address - Country:US
Mailing Address - Phone:915-742-0730
Mailing Address - Fax:915-742-7889
Practice Address - Street 1:36065 SANTA FE AVE FL 2
Practice Address - Street 2:
Practice Address - City:FORT CAVAZOS
Practice Address - State:TX
Practice Address - Zip Code:76544-5060
Practice Address - Country:US
Practice Address - Phone:254-553-3944
Practice Address - Fax:254-288-8875
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6388208D00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice