Provider Demographics
NPI:1821613936
Name:LABAUVE, ELLEN NICOLE (MD)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:NICOLE
Last Name:LABAUVE
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 1:7777 FOREST LN STE 1110
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LN STE D1110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2605
Practice Address - Country:US
Practice Address - Phone:214-824-3200
Practice Address - Fax:214-824-0541
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV2131207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology