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General NPI Number Information
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NPI Number | 1053675736
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Entity Type | Organization
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Legal Business Name | EC LEWISVILLE, LLC
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 4780 SH 121
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City | THE COLONY
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State | TX
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Zip | 75056-2913
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Country | US
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Telephone | 281-784-1500
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Fax | 281-784-1653
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Provider Business Mailing Address
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Address Line | 211 HIGHLAND CROSS DR SUITE 275
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City | HOUSTON
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State | TX
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Zip | 77073-1733
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Country | US
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Telephone | 281-784-1500
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Fax | 281-784-1653
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Authorized Official
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Title or Position | CEO
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Name | TIMOTHY SEAY
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Credential | M.D.
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Telephone | 281-784-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 160063
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License Number State | TX
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