MR. MARK D. ELLIS (NPI# 1508868530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508868530 |
| Entity Type | Individual |
| Full Name | MR. MARK D. ELLIS |
| Credential | N.P. |
| Practice Address |
11452 Space Center Blvd Houston TX 77059-3599 |
| Practice Telephone | 8327759800 |
| Practice Fax Number | 8327759819 |
| Mailing Telephone | 8327759800 |
| Mailing Fax Number | 8327759819 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2011-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
609633 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 8N3533 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972897080 | Mark Ellis | Podiatrist | 12592 S 150 E, Draper, UT 84020-8611 | 2011-06-06 |
| 1659682219 | Mark Kenneth Ellis | Emergency Medicine | 2 5th Ave Apt 2d, New York, NY 10011-8832 | 2010-06-29 |
| 1174661672 | Mark Joseph Ellis | Chiropractor | 41 Western Avenue, Rochester, NH 03867 | 2007-02-05 |
| 1336204171 | Mark J Ellis | Respiratory Therapist, Certified | 1101 Jefferson Blvd, Hagerstown, MD 21742-5037 | 2006-12-22 |
| 1184719262 | Mark Allen Ellis | Dentist | 910 Averitt Rd, Greenwood, IN 46143-9540 | 2006-10-04 |
| 1437240124 | Mark Owen Ellis | Podiatrist | 582 22nd Street, Astoria, OR 97103 | 2006-09-27 |
| 1083632244 | Mark Brian Ellis | Family Medicine | 1018 Rucker Blvd, Ste A, Enterprise, AL 36330-3675 | 2006-07-17 |
| 1265426894 | Mark Alan Ellis | Dentist | 951 Riverfront Pkwy, Suite 302, Chattanooga, TN 37402-2185 | 2005-09-09 |
| 1316580509 | Mark Duane Ellis | Licensed Practical Nurse | 2600 Se Belmont St, Portland, OR 97214-2916 | 2019-10-21 |
| 1629427752 | Mark Andrew Ellis | Otolaryngology | 169 Ashley Ave, Room 202 Main Hospital, Msc 333, Charleston, SC 29425-9080 | 2016-06-09 |
| Street Address |
11452 SPACE CENTER BLVD |
| City | HOUSTON |
| State | TX |
| Zip Code | 77059-3599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659372969 | Bayshore Family Practice P.a. | Family Medicine | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2005-08-09 |
| 1235610999 | Donna Francis Dozier | Social Worker | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2018-08-21 |
| 1700307675 | Christine River Block | Social Worker | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2017-06-30 |
| 1568815702 | Amina Moheyuddin | Family Medicine | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2016-07-22 |
| 1114382306 | Ut Physicians Specialty Services | Pediatrics | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2015-12-15 |
| 1013309285 | Thuy Thi Tran | Nurse Practitioner | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2015-02-25 |
| 1285053116 | Sheri Beck | Nurse Practitioner | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2014-04-08 |
| 1336491737 | Kaila Saxe | Nurse Practitioner | 11452 Space Center Blvd, Houston, TX 77059 | 2012-10-09 |
| 1881845634 | Beena Sattar | Internal Medicine | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2008-10-09 |
| 1215101522 | William B Perkison | Family Medicine | 11452 Space Center Blvd, Houston, TX 77059-3599 | 2008-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427531342 | Daniel R Orton | Clinical Medical Laboratory | 16422 Larkfield Dr, Houston, TX 77059 | 2018-09-07 |
| 1558890962 | Theodora Efroseni Tsakalakis | Specialist/Technologist | 15722 Dunmoor Dr., Houston, TX 77059 | 2017-06-08 |
| 1396273017 | Ashlon Waldel Albert | Dentist | 3535 Clear Lake City Blvd, Houston, TX 77059 | 2017-05-24 |
| 1669821161 | Sacred Oak Medical Center, LLC | Psychiatric Hospital | 11500 Space Center Blvd, Houston, TX 77059 | 2016-06-07 |
| 1023482999 | Ideal Dental of Clearlake Pllc | Dentist | 3535 Clear Lake City Boulevard, Suite 400, Houston, TX 77059 | 2015-11-16 |
| 1700262821 | H-e-b, Lp | Clinical Medical Laboratory | 3501 Clear Lake City Blvd, Houston, TX 77059 | 2015-07-31 |
| 1922389709 | Rita Yarbrough | Speech-Language Pathologist | 3707 Montvale, Houston, TX 77059 | 2011-09-07 |
| 1699916239 | Larna Annette Martin | Contractor | 16011 Parksely Dr., Houston, TX 77059 | 2009-03-11 |
| 1861534596 | David S. Morrow | Optometrist | 11510-b Space Center Blvd, Houston, TX 77059 | 2007-02-12 |
| 1952443681 | Catherine M. Brooks | Optometrist | 11510-b Space Center Blvd., Houston, TX 77059 | 2007-02-12 |
| Find all providers in zip 77059 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255162 | Shaida Rahmatinick | Nurse Practitioner | 1515 W 22nd St, Houston, TX 77008-1501 | 2020-11-08 |
| 1104426311 | Erin Krim Gordon | Nurse Practitioner | 2202 Quenby St, Houston, TX 77005-1502 | 2020-10-27 |
| 1003415902 | Hope Ozumba | Nurse Practitioner | 8544 Dairy View Ln, Houston, TX 77072-3907 | 2020-10-21 |
| 1487253761 | Khanh Vu Phuong Nguyen | Nurse Practitioner | 13218 Bellaire Bld, Houston, TX 77083 | 2020-10-19 |
| 1962001362 | Eshcol Clinic | Nurse Practitioner | 9935 Bissonnet St Unit B, Houston, TX 77036-8413 | 2020-10-19 |
| 1013516483 | Shazia Mominkhawaja | Nurse Practitioner | 2222 Greenhouse Rd Ste 400, Houston, TX 77084-7288 | 2020-10-18 |
| 1851908610 | Iyobo Elegon | Nurse Practitioner | 8511 Dawnridge Dr, Houston, TX 77071-2441 | 2020-09-25 |
| 1548877541 | Lifespan Psychiatry and Wellness Center Pllc | Nurse Practitioner | 8700 Commerce Park Dr Ste 220, Houston, TX 77036-7431 | 2020-09-24 |
| 1811503345 | Alyssa Cory Hildebrand | Nurse Practitioner | 2450 Fondren Rd Ste 111, Houston, TX 77063-2314 | 2020-09-21 |
| 1245846088 | Adriana Ortiz | Nurse Practitioner | 7218 Shady Corners Ln, Houston, TX 77040-4733 | 2020-09-17 |
| Find all providers in HOUSTON | ||||
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| 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.