MEDICARE: SELECT ER, 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
1	261QE0002X	Emergency Care Clinic/Center	32057311659	TX

General Provider Information

NPI Number	:	1811360142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT ER, LLC

Provider Business Mailing Address
First Line	:	15611 OYSTER COVE DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3364
Country	:	US
Telephone Number	:	832-367-2844
Fax Number	:

Provider Business Practice Location Address
First Line	:	3808 KEMP BLVD STE A
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2150
Country	:	US
Telephone Number	:	832-367-2844
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPAL PARTNER
Name	:	DR. GARY NEWMAN YEE
Credential	:	MD
Telephone Number	:	832-367-2844

Provider Enumeration Date	:	11/09/2015
Last Update Date	:	11/09/2015

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