RANDY KYLE ELLIS (NPI# 1487823191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487823191 |
| Entity Type | Individual |
| Full Name | RANDY KYLE ELLIS |
| Practice Address |
2015 Broadway St Pearland TX 77581-5698 |
| Practice Telephone | 2814856003 |
| Mailing Telephone | 2814856003 |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
15404 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487915344 | Randy R Ellis | Adult Companion | 304 Pearl St, Oregon City, OR 97045-2684 | 2012-06-06 |
| 1174605125 | Randy Wayne Ellis | Counselor | 1445 Vista Way, Red Bluff, CA 96080 | 2006-10-19 |
| 1811924590 | Randy S. Ellis | Emergency Medicine | 2001 N Oregon St, El Paso, TX 79902-3320 | 2006-06-27 |
| Street Address |
2015 BROADWAY ST |
| City | PEARLAND |
| State | TX |
| Zip Code | 77581-5698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720526593 | Ellis Moon Orthodontics, Pllc | Dentist | 2015 Broadway St, Suite A, Pearland, TX 77581-5698 | 2017-02-01 |
| 1134384217 | Lisa Richardson Dds PC | Dentist | 2015 Broadway St, Suite B, Pearland, TX 77581-5698 | 2008-07-28 |
| 1992969570 | Lisa G. Richardson | Dentist | 2015 Broadway St, Suite B, Pearland, TX 77581-5698 | 2008-07-14 |
| 1285710459 | Freddy R Cessac | Dentist | 2015 Broadway St, Ste B, Pearland, TX 77581-5501 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477171973 | Teledentist365 Foundation | Public Health or Welfare | 2111 Limrick Drive, Pearland, TX 77581 | 2020-07-10 |
| 1558984757 | Oculus Interest Vii, LLC | Optometrist | 2470 Pearland Pkwy, Pearland, TX 77581 | 2020-05-21 |
| 1285267591 | Rachel Daniels | Speech-Language Pathologist | 2011 E. Broadway, Ste. 130, Pearland, TX 77581 | 2020-02-14 |
| 1164054615 | Chau Minh Pho | Pharmacist | 3245 Fm518, Pearland, TX 77581 | 2020-02-12 |
| 1902460611 | Areli Dominguez | Behavior Technician | 6516 Broadway Street, Suite 112, Perland, TX 77581 | 2019-04-29 |
| 1700356359 | Rebekah Buck | Physical Therapist | 2011 E. Broadway Ste 130, Pearland, TX 77581 | 2018-11-27 |
| 1639676737 | Kjj Vision Pllc | Optometrist | 1816 Broadway St Ste 106, Pearland, TX 77581 | 2018-04-06 |
| 1386155398 | Tekisha Murphy | Nurse Practitioner | 2812 Afton Drive, Pearland, TX 77581 | 2017-10-17 |
| 1588181457 | Emily Hamm | Occupational Therapist | 211 E. Broadway, Ste. 130, Pearland, TX 77581 | 2017-08-23 |
| 1013437938 | Kristin Aulds | Dentist | 2708 Pearland Parkway, Ste 220, Pearland, TX 77581 | 2017-06-21 |
| Find all providers in zip 77581 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215463021 | Wint Wint Tun | Dentist | 1849 Pearland Pkwy # 101, Pearland, TX 77581-5016 | 2017-05-11 |
| 1073904439 | Devereux and Nguyen LLC | Dentist | 2251 County Road 94, Suite 102, Pearland, TX 77584-5137 | 2015-02-06 |
| 1487887980 | Dr. Elgin E. Wells | Dentist | 2251 County Road 94 Ste 102, Pearland, TX 77584-5137 | 2009-08-31 |
| 1164698031 | Wendy Struss Willett | Dentist | 10015 Broadway St Ste F, Pearland, TX 77584-7879 | 2008-05-01 |
| 1326236332 | Yesenia Garcia | Dentist | 12004 Shadow Creek Pkwy Ste 100, Pearland, TX 77584 | 2007-10-04 |
| 1124110861 | Sheela Kudchadker | Dentist | 9415 Broadway, Ste 119, Pearland, TX 77584-8094 | 2006-09-29 |
| 1720526593 | Ellis Moon Orthodontics, Pllc | Dentist | 2015 Broadway St, Suite A, Pearland, TX 77581-5698 | 2017-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989992 | Maxwell Oldham | Dentist | 115 Kohlers Xing Ste 350, Kyle, TX 78640-2467 | 2020-10-10 |
| 1154928943 | Amanda Gerlach | Dentist | 3550 Hulen St Ste C, Fort Worth, TX 76107-6885 | 2020-10-05 |
| 1700496411 | Farhana Rahman | Dentist | 398 E Pipeline Rd, Hurst, TX 76053-5831 | 2020-08-06 |
| 1093324675 | Frisco Braces Pllc | Dentist | 5285 Dallas Pkwy Ste 500, Frisco, TX 75034-9634 | 2020-07-29 |
| 1316556061 | Prosper Braces Pllc | Dentist | 821 N Coleman St Ste 110, Prosper, TX 75078-2305 | 2020-07-29 |
| 1871118133 | Tardy Orthodontics PC | Dentist | 8805 North Tarrant Parkway, Suite 200, North Richland Hills, TX 76182 | 2020-06-12 |
| 1285256636 | Bear Dental Corp | Dentist | 210 N. Coit Rd., Mckinney, TX 75071 | 2020-05-08 |
| 1275155665 | Joanna Song | Dentist | 2540 Fm 2920 Rd Ste H, Spring, TX 77388-3672 | 2020-05-08 |
| 1477175917 | Meredith Ann Williams | Dentist | 5215 Fm 1463 Rd Ste 700, Katy, TX 77494-7437 | 2020-05-06 |
| 1740809003 | Boss Orthodontics, Pllc | Dentist | 15801 W Hwy 71 Ste 600, Bee Cave, TX 78738-2709 | 2020-04-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RANDY KYLE 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.