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General NPI Number Information
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NPI Number | 1588786859
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Entity Type | Organization
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Legal Business Name | TOM ELLER, II, MD, PA
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 11/11/2013
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Provider Practice Location Address
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Address Line | 4401 COIT RD STE 313
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City | FRISCO
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State | TX
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Zip | 75035-0500
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Country | US
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Telephone | 254-624-7071
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Fax | 214-619-5222
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Provider Business Mailing Address
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Address Line | 4314 PAWNEE TRL
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-8654
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Country | US
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Telephone | 254-624-7071
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Fax | 214-619-5222
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS O. ELLER II
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Credential | M.D.
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Telephone | 254-624-7071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G7924
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License Number State | TX
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