Healthcare Provider Details

I. General information

NPI: 1407240229
Provider Name (Legal Business Name): EMERGENTCARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N MACARTHUR BLVD STE 203
IRVING TX
75038-6497
US

IV. Provider business mailing address

4301 N MACARTHUR BLVD STE 203
IRVING TX
75038-6497
US

V. Phone/Fax

Practice location:
  • Phone: 972-255-5588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA YOUNG
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 972-573-7950