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Andrea M Ellis, MD

Family Medicine Physician in Tyler, TX · enumerated 2008.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063661148

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Registry record

Entity type Individual (Type 1)
Name Andrea M Ellis
Credential MD
Sex Female
Practice address 8288 S Broadway Ave, Tyler, TX, 75703
Enumeration date Sep 15, 2008
Last updated in NPPES Dec 3, 2024

Taxonomy & licenses

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License BP10032729 (TX) Secondary
207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License N7419 (TX) Primary
MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier Type State Issuer
8CU926 Other TX BCBS
75-2616977-042 Other TX TRICARE
752616977077 Other TX TRICARE
284827701 Medicaid TX -
752616977118 Other TX TRICARE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How do I verify Andrea Ellis's NPI record?
Cross-check NPI 1063661148 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.
Is NPI 1063661148 active?
Yes, as of the latest NPPES snapshot, NPI 1063661148 is active (record last updated 2024-12-03).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-12-03.