Ellisiv Lien
Medical Specialty
Professional ID
- NPI: 1265670749
- PECOS ID: 3577629773
- Enrollment ID: I20090312000315
- Credential(MD, DO, DPM):
- Medical School:
- Medical School Graduation Year: 2000
Hospital Service
- Hospital CCN1: 450864
- Business Name (LBN)1: Texas Spine And Joint Hospital
Medical Practices
- Organization Name: Charles R. Gordon., Md, Pa
- Group Practice ID assigned by PECOS: 8729992052
- Number of Group Practice member: 25
Location
- Address1: 1814 Roseland Blvd
- Address2: Suite 201
- City: Tyler
- State: Texas
- Zip Code: 75701
- Phone Number: (903)592-6000
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR): Yes