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

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1265670749

Ellisiv Lien, MD is a Physical Medicine and Rehabilitation in Tyler, Texas. Qualified in 2000, 26 years ago. Practices with Charles R Gordon MD PA, a 25-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
26
Licensed in
TX
In the registry since
2009
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

2737 S Broadway Ave
Tyler, TX 75701-5413
Phone: (903) 592-6000
Fax: (903) 592-3224
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence N1735 (TX)

Record details

NPI number1265670749
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 22, 2009
Last updated in NPPESJanuary 31, 2019
Mailing addressPo Box 6605, Tyler, TX 75711-6605

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Charles R Gordon Md Pa — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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