1720337793 NPI number — PHYSICIAN ER LP

Table of content: (NPI 1720337793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720337793 NPI number — PHYSICIAN ER LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHYSICIAN ER LP
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:
1720337793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6750 WEST LOOP S
Provider Second Line Business Mailing Address:
STE 950
Provider Business Mailing Address City Name:
BELLAIRE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77401-4103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-838-0800
Provider Business Mailing Address Fax Number:
713-838-0887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6191 E SAM HOUSTON PKWY N
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77049-7201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-838-0800
Provider Business Practice Location Address Fax Number:
713-838-0887
Provider Enumeration Date:
09/05/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KERCHNER
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
T
Authorized Official Title or Position:
PROCESS IMPROVEMENT MANAGER
Authorized Official Telephone Number:
713-838-0800

Provider Taxonomy Codes

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

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





Copyright © 2007-2025 www.npivalidator.com