=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396131082
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASCENT GROUP LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2015
-----------------------------------------------------
Last Update Date | 04/09/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3607 OAK LAWN AVE
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75219-4311
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-838-0800
-----------------------------------------------------
Fax | 713-838-0887
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6800 WEST LOOP S STE 300
-----------------------------------------------------
City | BELLAIRE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77401-4528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-838-0800
-----------------------------------------------------
Fax | 713-838-0887
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | KAREN KUO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 870-268-1377
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QE0002X
-----------------------------------------------------
Taxonomy Name | Emergency Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------