MEDICARE: SUBURBAN EMERGENCY CENTER

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
1	261QX0100X	Occupational Medicine Clinic/Center
2	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1205935707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUBURBAN EMERGENCY CENTER

Provider Business Mailing Address
First Line	:	12345 KATY FREEWAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-1503
Country	:	US
Telephone Number	:	281-679-5600
Fax Number	:	281-759-5379

Provider Business Practice Location Address
First Line	:	12345 KATY FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-1503
Country	:	US
Telephone Number	:	281-679-5600
Fax Number	:	281-759-5379

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. PAT ROSS
Credential	:
Telephone Number	:	281-679-5600

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	09/11/2025

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