NPIMap

Organization Active NPI

R Lee Ennis MD PA

Doing business as Ronald L Ennis MD

  • Anatomic Pathology Physician
  • Denison, TX
National Provider Identifier
1457629503
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
Legal business name
R LEE ENNIS MD PA
Doing business as
Ronald L Ennis MD
Practice address
2402 W Morton Ste 146
Denison, TX 75020
Phone
(903) 465-7313
Fax
(903) 463-4496
NPI assigned
Dec 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ronald L Ennis, MD
Title
President
Phone
(903) 465-7313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0101X Primary

Addresses

Primary practice location

2402 W Morton Ste 146
Denison, TX 75020

Mailing address

PO Box 626
Denison, TX 75021-0626
Phone (903) 465-7313

Other identifiers 1

IdentifierTypeStateIssuer
097089901MedicaidTX

Other names 1

  • RONALD L ENNIS MD Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1457629503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750210626",
            "telephone_number": "903-465-7313",
            "fax_number": "903-463-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 W MORTON STE 146",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "75020",
            "telephone_number": "903-465-7313",
            "fax_number": "903-463-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R LEE ENNIS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "ENNIS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-465-7313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097089901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RONALD L ENNIS MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.