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NPI Code Detail

MEDICARE: DR. JAMES E. ELY MD

MEDICARE: DR. JAMES E. ELY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianG4572TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110578746OTHERCAQH
2H08DD46101OTHERTXBCBS OF TX
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821052358
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES E. ELY MD
Provider Business Mailing Address
First Line : 2100 REGIONAL MEDICAL DR
Second Line :
City : WHARTON
State : TX
Zip : 77488-9719
Country : US
Telephone Number : 979-532-1700
Fax Number : 979-532-4584
Provider Business Practice Location Address
First Line : 111 AVENUE F
Second Line :
City : BAY CITY
State : TX
Zip : 77414-4117
Country : US
Telephone Number : 979-245-2008
Fax Number : 979-245-0255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 05/15/2020

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