Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC2481 | TX |
NPI | 1487635058 |
---|---|
Provider Name | Dr. Steven Ray Elliott |
First Address | Lufkin, TX 75901-5754 |
Second Address | Lufkin, TX 75901-5754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 08/07/2007 |