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General NPI Number Information
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NPI Number | 1821089095
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Entity Type | Individual
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Provider Name | ELLEN JEAN REMENCHIK MD
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Gender | Female
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 103 CANNERY ROW
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City | LINDALE
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State | TX
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Zip | 75771
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Country | US
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Telephone | 903-882-3194
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Fax | 903-882-7405
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Provider Business Mailing Address
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Address Line | 103 CANNERY ROW
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City | LINDALE
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State | TX
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Zip | 75771
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Country | US
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Telephone | 903-882-3194
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Fax | 903-882-7405
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G8366
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | 35447
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | G8366
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 196118
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License Number State | CA
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