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NPI Code Detail

MEDICARE: DR. HENRY BONE ELLIS JR. M.D.

MEDICARE: DR. HENRY BONE ELLIS JR. M.D.
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
1207XP3100XPediatric Orthopaedic Surgery PhysicianN 3019TX
2207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianN 3019TX

General Provider Information

NPI Number : 1821200494
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HENRY BONE ELLIS JR. M.D.
Provider Business Mailing Address
First Line : 2222 WELBORN ST
Second Line :
City : DALLAS
State : TX
Zip : 75219-3924
Country : US
Telephone Number : 214-559-5000
Fax Number : 214-443-7309
Provider Business Practice Location Address
First Line : 5700 DALLAS PKWY
Second Line :
City : FRISCO
State : TX
Zip : 75034-9580
Country : US
Telephone Number : 469-515-7100
Fax Number : 214-443-7309
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 03/07/2019

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