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General NPI Number Information
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NPI Number | 1982889911
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Entity Type | Organization
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Legal Business Name | ELLIS COUNTY SURGICAL ASSOCIATES PA
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 1626 W HIGHWAY 287 BUSINESS SUITE 102
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City | WAXAHACHIE
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State | TX
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Zip | 75165-4712
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Country | US
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Telephone | 972-923-2600
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Fax | 972-923-1013
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Provider Business Mailing Address
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Address Line | 1626 W HIGHWAY 287 BUSINESS SUITE 102
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City | WAXAHACHIE
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State | TX
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Zip | 75165-4712
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Country | US
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Telephone | 972-923-2600
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Fax | 972-923-1013
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YOMI JOSEPH FAYIGA
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Credential | MD
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Telephone | 972-923-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | H9921
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License Number State | TX
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