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General NPI Number Information
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NPI Number | 1164900239
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Entity Type | Organization
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Legal Business Name | PROVIDENCE ER OF RAYFORD PLLC
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Dates
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Enumeration Date | 08/01/2018
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 2306 RAYFORD RD
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City | SPRING
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State | TX
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Zip | 77386
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Country | US
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Telephone | 832-482-9595
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Fax | 832-482-9596
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Provider Business Mailing Address
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Address Line | 2306 RAYFORD RD
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City | SPRING
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State | TX
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Zip | 77386-1707
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | HUONG LE
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Credential | MD
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Telephone | 281-453-7777
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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 |
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License Number State |
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