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NPI Code Detail

MEDICARE: EMERGENCY MEDICAL GROUP, LLC

MEDICARE: EMERGENCY MEDICAL GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0002XEmergency Care Clinic/Center160025TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1H0HH031EOTHERTXBLUE CROSS BLUE SHIELD OF TEXAS
2160025OTHERTXFREESTANDING EMERGENCY MEDICAL CARE FACILITY

General Provider Information

NPI Number : 1134417439
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMERGENCY MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : 2500 RICE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77005-3221
Country : US
Telephone Number : 713-527-4400
Fax Number : 281-784-1653
Provider Business Practice Location Address
First Line : 2500 RICE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77005-3221
Country : US
Telephone Number : 713-527-4400
Fax Number : 281-784-1653
Authorized Official
Title or Position : ADMINISTRATOR
Name : TIMOTHY SEAY
Credential : M.D.
Telephone Number : 281-784-1500
Provider Enumeration Date : 07/20/2011
Last Update Date : 04/08/2015

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