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

MS. Yanique Tavia Ellis, MD

Individual provider Pediatrics Physician · NPI 1093382939

MS. Yanique Tavia Ellis, MD is a Pediatrics Physician in Tyler, Texas. Licensed in Texas. Registered with an NPI since 2021.

Licensed in
TX
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

2900 N Broadway Ave
Tyler, TX 75702
Phone: (903) 593-1892
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence V0728 (TX)

Record details

NPI number1093382939
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 9, 2021
Last updated in NPPESDecember 2, 2024
Certification dateNovember 27, 2024

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