Healthcare Provider Details
I. General information
NPI: 1962456459
Provider Name (Legal Business Name): EMERGIGROUP PHYSICIAN ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2006
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16655 SOUTHWEST FWY
SUGAR LAND TX
77479-2329
US
IV. Provider business mailing address
5121 MARYLAND WAY STE 300
BRENTWOOD TN
37027-7516
US
V. Phone/Fax
- Phone: 281-274-7000
- Fax:
- Phone: 629-203-7320
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
GRIMES
Title or Position: CFO
Credential:
Phone: 615-551-6611