1801390380 NPI number — HARBOR EMERGENCY PHYSICIANS PA

Table of content: (NPI 1801390380)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801390380 NPI number — HARBOR EMERGENCY PHYSICIANS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARBOR EMERGENCY PHYSICIANS PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801390380
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2320 S SHEPHERD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77019-7014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-526-2320
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3725 E LEAGUE CITY PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEAGUE CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77573-7373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-549-7032
Provider Business Practice Location Address Fax Number:
281-549-7036
Provider Enumeration Date:
03/20/2018

Additional Information

Authorized Official

Authorized Official Last Name:
LUNA
Authorized Official First Name:
HORTENCIA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
832-978-6353

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1295757060 . This is a "SUZANNA CRUZ" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1669457404 . This is a "BLAKE CHAMBERLAIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: V . This is a "THANG NGUYEN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1720009590 . This is a "WESLEY NAHM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1801390380 . This is a "HARBOR EMERGENCY PHYSICIANS PA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1972583110 . This is a "DARRYN MYERS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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