1447554191 NPI number — MEMORIAL EMERGENCY PHYSICIANS P.A.

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 1447554191 NPI number — MEMORIAL EMERGENCY PHYSICIANS P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEMORIAL EMERGENCY PHYSICIANS P.A.
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:
1447554191
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
05/05/2023
NPI Reactivation Date:
07/26/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 HIBURY 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:
77024-7141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-358-0200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9774 KATY FWY
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77055-6223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-358-0200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MENDOZA
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
832-358-0200

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  L3765 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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