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General NPI Number Information
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NPI Number | 1477130276
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Entity Type | Organization
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Legal Business Name | SOUTH LAMAR AUSTIN EMERGENCY CENTER, LLC
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 4015 S LAMAR BLVD
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City | AUSTIN
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State | TX
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Zip | 78704-7966
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Country | US
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Telephone | 512-598-8901
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 WEST LOOP S STE 450
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City | HOUSTON
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State | TX
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Zip | 77027-9510
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Country | US
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Telephone | 832-230-8100
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Fax |
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Authorized Official
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Title or Position | COO
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Name | KRAIG KILLOUGH
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Credential |
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Telephone | 832-230-8100
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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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