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General NPI Number Information
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NPI Number | 1336393479
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Entity Type | Individual
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Provider Name | RACHEL JOY ELLSWORTH M.D
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Gender | Female
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 18400 KATY FWY SUITE 560
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City | HOUSTON
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State | TX
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Zip | 77094-1286
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Country | US
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Telephone | 832-522-3240
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Fax | 281-578-2404
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Provider Business Mailing Address
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Address Line | 18400 KATY FWY SUITE 560
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City | HOUSTON
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State | TX
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Zip | 77094-1286
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Country | US
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Telephone | 832-522-3240
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Fax | 281-578-2404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | TMB PIT#
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | N1878
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License Number State | TX
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