Provider Demographics
NPI:1215913751
Name:ELTERMAN, ROY D (MD)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:D
Last Name:ELTERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:B116
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2507
Mailing Address - Country:US
Mailing Address - Phone:972-566-8600
Mailing Address - Fax:972-566-8601
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:B116
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2507
Practice Address - Country:US
Practice Address - Phone:972-566-8600
Practice Address - Fax:972-566-8601
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2011-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE91882084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B22529Medicare UPIN