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NPI 1104048230

NPI 1104048230 : STEEPLETOP EMERGENCY PHYSICIANS : CYPRESS, TX

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General NPI Number Information
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    NPI Number           |    1104048230
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    Entity Type          |    Organization 
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    Legal Business Name  |    STEEPLETOP EMERGENCY PHYSICIANS 
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Dates
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    Enumeration Date     |    05/02/2007
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    Last Update Date     |    04/20/2008
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Provider Practice Location Address
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    Address Line         |    9110 BARKER CYPRESS SUITE 100
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    City                 |    CYPRESS
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    State                |    TX
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    Zip                  |    77443
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    Country              |    US
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    Telephone            |    214-712-2000
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    Fax                  |    214-712-2487
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Provider Business Mailing Address
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    Address Line         |    1717 MAIN ST SUITE 5200
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75201-4612
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    Country              |    US
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    Telephone            |    214-712-2000
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    Fax                  |    214-712-2487
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     WILLAIM C. JERNBERG 
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    Credential           |    MD
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    Telephone            |    214-712-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    
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    License Number State |    
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