Provider Demographics
NPI:1427614841
Name:DAVID P ELLENT PLLC
Entity type:Organization
Organization Name:DAVID P ELLENT PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-440-5300
Mailing Address - Street 1:8845 SIX PINES DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2675
Mailing Address - Country:US
Mailing Address - Phone:281-465-1767
Mailing Address - Fax:281-298-3367
Practice Address - Street 1:8845 SIX PINES DR STE 201
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-2675
Practice Address - Country:US
Practice Address - Phone:281-465-1767
Practice Address - Fax:281-298-3367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID P. ELLENT PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-10
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy