Healthcare Provider Details

I. General information

NPI: 1205935707
Provider Name (Legal Business Name): SUBURBAN EMERGENCY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12345 KATY FWY
HOUSTON TX
77079-1503
US

IV. Provider business mailing address

12345 KATY FREEWAY
HOUSTON TX
77079-1503
US

V. Phone/Fax

Practice location:
  • Phone: 281-679-5600
  • Fax: 281-759-5379
Mailing address:
  • Phone: 281-679-5600
  • Fax: 281-759-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAT ROSS
Title or Position: ADMINISTRATOR
Credential:
Phone: 281-679-5600