MEDICARE: KIRBY EMERGENCY PHYSICIANS PLLC

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	207P00000X	Emergency Medicine Physician		TX

General Provider Information

NPI Number	:	1568699445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIRBY EMERGENCY PHYSICIANS PLLC

Provider Business Mailing Address
First Line	:	5121 MARYLAND WAY STE 300
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7516
Country	:	US
Telephone Number	:	292-037-3206
Fax Number	:

Provider Business Practice Location Address
First Line	:	2615 SOUTHWEST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4609
Country	:	US
Telephone Number	:	713-441-2194
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JAMES GRIMES
Credential	:
Telephone Number	:	615-551-6611

Provider Enumeration Date	:	06/17/2009
Last Update Date	:	01/27/2023

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