Ellis Surgical Pavilion, LLC
NPI #1336331917 in Waxahachie, Texas
Provider Information
- NPI Number
- 1336331917
- Entity Type
- Organization
- Organization Name
- Ellis Surgical Pavilion, LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Aug 16, 2007
- Last Updated
- Aug 16, 2007
Practice Location
- Address
- 1014 FERRIS AVE
- Address 2
- STE. 214
- City
- Waxahachie
- State
- Texas
- ZIP Code
- 75165-2599
- Phone
- (972) 938-1368
Authorized Official
- Name
- DR. J. D. FAJARDO, D.P.M.
- Title
- CEO
- Phone
- (972) 938-1368
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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