Healthcare Provider Details

I. General information

NPI: 1255996906
Provider Name (Legal Business Name): ELLEN LANDRY MINALDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLEN MARGARET LANDRY

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18200 KATY FWY
HOUSTON TX
77094-1285
US

IV. Provider business mailing address

18200 KATY FWY
HOUSTON TX
77094-1285
US

V. Phone/Fax

Practice location:
  • Phone: 832-227-2280
  • Fax:
Mailing address:
  • Phone: 832-227-2280
  • Fax: 832-227-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberW8051
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW8051
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: