Healthcare Provider Details

I. General information

NPI: 1760424162
Provider Name (Legal Business Name): TOWN AND COUNTRY EMERGENCY PHYSICIANS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 SOUTHWEST FWY
SUGAR LAND TX
77479-2311
US

IV. Provider business mailing address

4405 SPRING CYPRESS RD SUITE 204
SPRING TX
77388-4400
US

V. Phone/Fax

Practice location:
  • Phone: 281-277-0911
  • Fax:
Mailing address:
  • Phone: 281-297-2257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: HOMER D KIRBY
Title or Position: PRESIDENT
Credential: MD
Phone: 281-277-0911