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General NPI Number Information
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NPI Number | 1750411989
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Entity Type | Individual
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Provider Name | RICHARD ELLIOTT PARENT D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1143 S BUCKNER BLVD
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City | DALLAS
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State | TX
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Zip | 75217-4304
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Country | US
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Telephone | 214-398-8383
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Fax | 214-398-8686
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Provider Business Mailing Address
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Address Line | 237 KESWICK LN
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City | MESQUITE
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State | TX
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Zip | 75150-8213
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Country | US
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Telephone | 972-226-4751
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Fax | 972-226-4754
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | E5880
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License Number State | TX
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