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General NPI Number Information
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NPI Number | 1043641749
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Entity Type | Organization
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Legal Business Name | CR EMERGENCY ROOM, LLC
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Dates
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Enumeration Date | 12/05/2013
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 5500 COLLEYVILLE BLVD
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City | COLLEYVILLE
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State | TX
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Zip | 76034
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Country | US
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Telephone | 214-294-6350
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Fax | 713-637-1305
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Provider Business Mailing Address
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Address Line | 8686 NEW TRAILS DR SUITE 100
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City | THE WOODLANDS
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State | TX
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Zip | 77381-1176
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Country | US
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Telephone | 713-929-2076
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Fax | 281-292-3585
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT COORDINATOR
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Name | TINA JOHNSON
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Credential |
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Telephone | 713-929-2076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | NULL
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