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General NPI Number Information
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NPI Number | 1962373654
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Entity Type | Individual
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Provider Name | CHRISTIANA G ELLISON PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 10/05/2025
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Provider Practice Location Address
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Address Line | 6560 FANNIN ST STE 1842
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City | HOUSTON
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State | TX
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Zip | 77030-2715
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Country | US
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Telephone | 713-790-2089
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Fax | 713-794-0576
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Provider Business Mailing Address
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Address Line | 6560 FANNIN ST STE 1842
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City | HOUSTON
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State | TX
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Zip | 77030-2715
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Country | US
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Telephone | 713-790-2089
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Fax | 713-794-0576
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | PA19496
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License Number State | TX
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