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NPI Code Detail

MEDICARE: TEXAS EM-1 MEDICAL SERVICES, PA

MEDICARE: TEXAS EM-1 MEDICAL SERVICES, PA
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
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1942253083
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXAS EM-1 MEDICAL SERVICES, PA
Provider Business Mailing Address
First Line : PO BOX 41797
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-1797
Country : US
Telephone Number : 214-712-2000
Fax Number : 214-712-2487
Provider Business Practice Location Address
First Line : 9440 POPPY DR
Second Line :
City : DALLAS
State : TX
Zip : 75218-3652
Country : US
Telephone Number : 254-519-8405
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. WILLIAM C JERNBERG
Credential : MD
Telephone Number : 214-712-2000
Provider Enumeration Date : 05/18/2006
Last Update Date : 03/24/2008

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Directions to “TEXAS EM-1 MEDICAL SERVICES, PA ” Practice Location

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