Dr Beau James Ellenbecker, DO | |
610 E Byron Nelson Blvd, Suite 101, Roanoke, TX 76262-6541 | |
(817) 912-8200 | |
(817) 912-8210 |
Full Name | Dr Beau James Ellenbecker |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 18 Years |
Location | 610 E Byron Nelson Blvd, Roanoke, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679774582 | NPI | - | NPPES |
307543401 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | P1069 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Encompass Home Health Of Dfw | Grapevine, TX | Home health agency |
Baylor Scott & White Medical Center Grapevine | Grapevine, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Healthtexas Provider Network | 1355254210 | 1844 |
Entity Name | Healthtexas Provider Network |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760488936 PECOS PAC ID: 1355254210 Enrollment ID: O20040727001187 |
Mailing Address | Practice Location Address |
---|---|
Dr Beau James Ellenbecker, DO 610 E Byron Nelson Blvd, Suite 101, Roanoke, TX 76262-6541 Ph: (817) 912-8200 | Dr Beau James Ellenbecker, DO 610 E Byron Nelson Blvd, Suite 101, Roanoke, TX 76262-6541 Ph: (817) 912-8200 |
Anna Wallace, APRN Family Medicine Medicare: Medicare Enrolled Practice Location: 208 N Highway 377, Roanoke, TX 76262 Phone: 682-237-7600 | |
Dr. Jeffrey Brad Griffin, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 509 E Byron Nelson Blvd, Suite B, Roanoke, TX 76262 Phone: 817-491-2564 Fax: 817-491-3420 |