Wade Ellisor, OD

NPI #1497138572 in Kingwood, Texas

Provider Information

NPI Number: 1497138572
Entity Type: Individual
Name: Wade Ellisor, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jul 7, 2015
Last Updated: Jul 7, 2015

Practice Location

Address: 1714 KINGWOOD DR
City: Kingwood
State: Texas
ZIP Code: 77339-3046
Phone: (281) 359-2020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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