| Doctor Name: | DR. ABIGAIL LYNN ELLIOTT |
| NPI Number: | 1053686725 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.M. |
| License Number: | 2101 |
| Business Practice Address: | 690 S Loop 336 W Suite 150 Conroe, TX - 773043319 |
| Business Phone Number: | 9367601200 |
| Business Fax Number: | 9367601210 |
| Mailing Address: | 690 S Loop 336 W, Suite 150 CONROE |
| State: | TX |
| Postal Code: | 773043319 |
| Phone Number: | 9367601200 |
| Fax Number: | 9367601210 |
| NPI Enumeration Date: | 03/14/2012 |
| NPI Last Update Date: | 01/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 2101 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |