| Dr Anthony John Elisco Iii, DO | |
|
4211 Joe Ramsey Blvd E Ste 100, Greenville, TX 75401-7856 | |
| (903) 408-7930 | |
| (903) 408-7929 |
| Full Name | Dr Anthony John Elisco Iii |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 35 Years |
| Location | 4211 Joe Ramsey Blvd E Ste 100, Greenville, 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 |
|---|---|---|---|
| 1922021856 | NPI | - | NPPES |
| 366443501 | Medicaid | TX | |
| 539307YMPG | Other | TX | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | OS007527L (Pennsylvania) | Secondary |
| 208800000X | Urology | Q9805 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hunt Regional Medical Center | Greenville, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hunt Regional Medical Partners Specialists | 7810226115 | 16 |
| Entity Name | Hunt Memorial Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598750721 PECOS PAC ID: 6406768936 Enrollment ID: O20040424000352 |
| Entity Name | Hunt Regional Medical Partners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235435892 PECOS PAC ID: 7517137748 Enrollment ID: O20110826000158 |
| Entity Name | Hunt Regional Medical Partners Specialists |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275031205 PECOS PAC ID: 7810226115 Enrollment ID: O20190912000065 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Anthony John Elisco Iii, DO 501 Air Park Ave, Greenville, TX 75402-3000 Ph: (903) 408-5834 | Dr Anthony John Elisco Iii, DO 4211 Joe Ramsey Blvd E Ste 100, Greenville, TX 75401-7856 Ph: (903) 408-7930 |
James Howard Sandin, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 4818 Welllington, Suite 4, Greenville, TX 75402 Phone: 903-455-0955 Fax: 903-455-0356 |