Most Relevant Information
Provider Data
| NPI Number: | 1003177536 |
| Provider Name: | ELORA PATTANAIK CORBIN M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/31/2012 |
| Last Updated: | 04/14/2021 |
Provider Practice Location
1500 COOPER ST
FORT WORTH
TX
761042710
Practice Location Phone/Fax
| Phone: | 6828852500 |
| Fax: | 6828852510 |
Provider Mailing Location
PO BOX 733784
DALLAS
TX
753733784
Provider Mailing Phone/Fax
| Phone: | 6828851855 |
| Fax: | 6828851396 |