Healthcare Provider Details

I. General information

NPI: 1861941494
Provider Name (Legal Business Name): EAGLE PASS ER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2114 N VETERANS BLVD
EAGLE PASS TX
78852
US

IV. Provider business mailing address

2114 N VETERANS BLVD
EAGLE PASS TX
78852
US

V. Phone/Fax

Practice location:
  • Phone: 830-522-3000
  • Fax:
Mailing address:
  • Phone: 830-522-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. TOM VO
Title or Position: MANAGER
Credential: M.D.
Phone: 713-660-0557