Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Colette Mark Ellis, MD

Individual provider Surgery Physician · NPI 1629530225

Colette Mark Ellis, MD is a Surgery Physician in Fairborn, Ohio. Licensed in Texas. Registered with an NPI since 2019.

Licensed in
TX
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1059 Baywood Dr
Fairborn, OH 45324-2647
Phone: (713) 339-0341
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence S8030 (TX)
Surgery Physician Taxonomy 208600000X · Licence S8030 (TX)

Record details

NPI number1629530225
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 2, 2019
Last updated in NPPESJuly 27, 2022
Certification dateJuly 27, 2022
Mailing address1059 Baywood Dr, Fairborn, OH 45324-2647

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