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General NPI Number Information
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NPI Number | 1689860389
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Entity Type | Individual
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Provider Name | CHANDRA VARNER ELLIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 7700 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3902
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Country | US
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Telephone | 210-575-2876
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Fax | 888-849-4257
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Provider Business Mailing Address
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Address Line | 307 DEVON DR
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3709
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Country | US
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Telephone | 415-491-1210
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Fax | 888-849-4257
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | S5161
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | S5161
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | S5161
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License Number State | TX
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