Healthcare Provider Details
I. General information
NPI: 1467070698
Provider Name (Legal Business Name): EMER ROWLETT PHYSICIANS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2020
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3301 LAKEVIEW PKWY
ROWLETT TX
75088-3321
US
IV. Provider business mailing address
2300 MATLOCK RD STE 35
MANSFIELD TX
76063-5018
US
V. Phone/Fax
- Phone: 469-304-0282
- Fax: 817-304-0258
- Phone: 469-830-8200
- Fax: 469-830-8201
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELLE
NEWSOM
Title or Position: PRESIDENT
Credential:
Phone: 469-830-8200