ROBERT S ELLIS (NPI# 1093864027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093864027 |
Entity Type | Individual |
Full Name | ROBERT S ELLIS |
Credential | MD |
Practice Address |
910 E Houston St Ste 530 Tyler TX 75702-8369 |
Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
Practice Telephone | 9035315560 |
Mailing Telephone | 9033246450 |
Enumeration Date | 2007-01-09 |
Last Update Date | 2016-02-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
M1656 | TX | Allopathic & Osteopathic Physicians |
Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
M1656 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
BCBS | 86515S | 01 | |
TX | TRICARE | TIN PLUS 096 | 01 |
TX | 178944801 | 05 | |
TX | BCBS OF TEXAS | 8BC264 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881945566 | Robert Ray Ellis | Military Health Care Provider | 10194 Cottage Ct, Diberville, MS 39540-4744 | 2012-09-21 |
1336392224 | Robert Ellis | Specialist/Technologist, Other | 8008 Blue Hole Ct, Mckinney, TX 75070-4896 | 2008-10-23 |
1124274394 | Robert Stephen Ellis | Dentist | 1434 - Parker Drive, Laurel, MS 39440-1942 | 2008-08-07 |
1083810709 | Robert Haig Ellis | Internal Medicine | 2412 Brookwood Drive, Fort Collins, CO 80525-1908 | 2007-06-21 |
1265534697 | Robert Frank Ellis | Obstetrics & Gynecology | 770 Elysian Way, Deerfield, IL 60015-4500 | 2006-09-05 |
1083724843 | Robert Lynn Ellis | Dentist | 143 1/2 E Main, Rigby, ID 83442 | 2006-08-30 |
1932111739 | Robert George Ellis | Radiology | 1204 E 29th St, Tulsa, OK 74114-3907 | 2006-08-12 |
1366461337 | Robert Earle Ellis | Counselor | 273 Front St, Weymouth, MA 02188-2202 | 2006-07-19 |
1124006549 | Robert William Ellis IIi | Psychiatry & Neurology | 204 W Grand River Ave, Suite 260, Howell, MI 48843-2299 | 2006-01-05 |
1689185936 | Robert Brian Ellis | Audiologist | 318 W El Norte Pkwy, Escondido, CA 92026-1925 | 2017-10-13 |
Street Address |
910 E HOUSTON ST STE 530 |
City | TYLER |
State | TX |
Zip Code | 75702-8369 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518962299 | Nina Beth Partin | Physician Assistant | 910 E Houston St, Ste 550, Tyler, TX 75702-8369 | 2005-06-17 |
1396212437 | Courtney Elizabeth Clifton | Nurse Practitioner | 910 E Houston St, Tyler, TX 75702-8369 | 2018-10-26 |
1275991994 | Good News Medical, Pllc | Family Medicine | 910 E Houston St, Tyler, TX 75702-8369 | 2016-02-09 |
1154788941 | April Michelle Coursey | Nurse Practitioner | 910 E Houston St, Ste 550, Tyler, TX 75702-8369 | 2016-01-25 |
1417343526 | Dana R Pillans | Nurse Practitioner | 910 E Houston St, Ste 530, Tyler, TX 75702-8369 | 2015-04-15 |
1770973844 | Sharon L Brooks | Registered Nurse | 910 E Houston St, Ste. 550, Tyler, TX 75702-8369 | 2015-01-28 |
1376948620 | Kirsten Stuber | Nurse Practitioner | 910 E Houston St, Suite 100, Tyler, TX 75702-8369 | 2014-10-29 |
1417352931 | Texas Oncology, P.a. | Clinic/Center | 910 E Houston St, Suite 100, Tyler, TX 75702-8369 | 2014-10-27 |
1811241292 | Mandy Green | Nurse Practitioner | 910 E Houston St, Ste 230, Tyler, TX 75702-8369 | 2012-11-06 |
1902158751 | Ashley Lesniewski | Nurse Practitioner | 910 E Houston St, Suite 330, Tyler, TX 75702-8369 | 2012-10-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
Find all providers in zip 75702 |
Taxonomy Code | 2086S0127X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Trauma Surgery |
Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184671190 | Mother Frances Hospital | Surgery | 612 S Fleishel Ave, Tyler, TX 75701-2012 | 2006-05-27 |
1063915916 | Tyler Regional Hospital LLC | Surgery | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-03-16 |
1871735852 | Melissa E Cloonan | Surgery | 910 E Houston St, Ste. 530, Tyler, TX 75702-8369 | 2009-04-06 |
1861417552 | David H Villarreal | Surgery | 1020 E Idel St, Tyler, TX 75701-2024 | 2006-07-13 |
1730131681 | Luis G Fernandez | Surgery | 910 E Houston St, Ste 530, Tyler, TX 75702-8369 | 2006-05-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174034623 | Stat Trauma & Surgical Services, Pllc | Surgery | 6 Garden Ln, Arlington, TX 76016 | 2017-10-23 |
1487164604 | Urgent Specialty Associates Pllc | Surgery | 4100 Spring Valley Rd Ste 250, Farmers Branch, TX 75244-3645 | 2017-10-02 |
1578969788 | Advanced Fracture Care Solutions Pllc | Surgery | 2145 Sutton Pl, Plano, TX 75093-4323 | 2014-11-16 |
1952737371 | Ernest A Gonzalez Md Pa | Surgery | 12319 N Mopac Expy Ste 350, Austin, TX 78758-2512 | 2013-09-17 |
1831393735 | Alexander Laurance Eastman | Surgery | 5323 Harry Hines Blvd # Mc9158, Department of Surgery--btcc, Dallas, TX 75390-9158 | 2007-06-13 |
1669592242 | Surgical Consultants Pa | Surgery | 6210 Wooldridge Rd Ste A, Corpus Christi, TX 78414-2528 | 2007-03-29 |
1144240508 | Ted R. Smith | Surgery | 50 Hillcrest Medical Blvd Ste 105, Waco, TX 76712-8953 | 2006-07-20 |
1750310520 | Matthew A Lovitt | Surgery | 2710 Swiss Avenue, Dallas, TX 75204-5900 | 2006-07-02 |
1730115270 | Jimie Dianne Owsley | Surgery | 810 Morgan Ave Apt 1, Corpus Christi, TX 78404-2058 | 2006-06-25 |
1578500815 | Advanced Laparoendoscopic Surgery, Pllc | Surgery | 3005 West Loop S, Suite 225, Houston, TX 77027-6100 | 2006-06-02 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on ROBERT S ELLIS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.