Healthcare Provider Details

I. General information

NPI: 1659744662
Provider Name (Legal Business Name): ER24 DENTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 LILLIAN MILLER PKWY
DENTON TX
76205-2908
US

IV. Provider business mailing address

2300 MATLOCK RD STE 35
MANSFIELD TX
76063-5018
US

V. Phone/Fax

Practice location:
  • Phone: 972-954-2133
  • Fax: 888-770-6360
Mailing address:
  • Phone: 469-830-8200
  • Fax: 469-830-8201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number13764
License Number StateTX

VIII. Authorized Official

Name: MICHELLE NEWSOM
Title or Position: PRESIDENT
Credential:
Phone: 469-830-8200