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General NPI Number Information
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NPI Number | 1407010622
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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 | 07/16/2008
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 26791 HIGHWAY 380
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City | AUBREY
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State | TX
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Zip | 76227-7654
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Country | US
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Telephone | 972-347-2525
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Fax | 972-347-6725
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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 | 281-292-0769
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Fax | 281-292-5748
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT COORDINATOR
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Name | MRS. 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 |
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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 | 008732
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License Number State | TX
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