Provider Demographics
NPI:1811151954
Name:MARTIN MCELYA DO PA
Entity type:Organization
Organization Name:MARTIN MCELYA DO PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-726-6464
Mailing Address - Street 1:5917 BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7703
Mailing Address - Country:US
Mailing Address - Phone:972-726-6464
Mailing Address - Fax:972-726-6444
Practice Address - Street 1:5917 BELT LINE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7703
Practice Address - Country:US
Practice Address - Phone:972-726-6464
Practice Address - Fax:972-726-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213ES0103X, 207Q00000X
TXK1555261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty