| Organization Name: | ELLITE MEDICAL SERVICES, INC |
| NPI Number: | 1578867271 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELLIE NENE OTI (PRESIDENT) |
| Mailing Address: | 2664 Whispering Trl Little Elm |
| State: | TX US |
| Postal Code: | 750686901 |
| Phone Number: | 2147180650 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2011 |
| NPI Last Update Date: | 01/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA03161 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |