Healthcare Provider Details

I. General information

NPI: 1467317024
Provider Name (Legal Business Name): ELLIE SADDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 WESTRIDGE CIR N STE 500
IRVING TX
75038-2424
US

IV. Provider business mailing address

6550 SHADY BROOK LN APT 837
DALLAS TX
75206-1213
US

V. Phone/Fax

Practice location:
  • Phone: 214-467-9787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1407725
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: