1265384945 NPI number — SOUTH COLLEGE STATION EMERGENCY CENTER, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265384945 NPI number — SOUTH COLLEGE STATION EMERGENCY CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH COLLEGE STATION EMERGENCY CENTER, LLC
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:
6
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:
1265384945
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11490 WESTHEIMER RD STE 1000
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:
77077-6853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-699-3777
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
948 WILLIAM D FITCH PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLLEGE STATION
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77845-6452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-231-3990
Provider Business Practice Location Address Fax Number:
281-752-7975
Provider Enumeration Date:
02/13/2026

Additional Information

Authorized Official

Authorized Official Last Name:
HANNAN
Authorized Official First Name:
HASHIBUL
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
832-699-3777

Provider Taxonomy Codes

  • Taxonomy code: 261QE0002X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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