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General NPI Number Information
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NPI Number | 1558844258
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Entity Type | Organization
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Legal Business Name | PREMIER ER PLUS, SAN MARCOS, LLC
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 1509 N INTERSTATE 35
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City | SAN MARCOS
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State | TX
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Zip | 78666-7220
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Country | US
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Telephone | 512-648-6188
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Fax |
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Provider Business Mailing Address
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Address Line | 900 AUSTIN AVE STE 1001
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City | WACO
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State | TX
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Zip | 76701-1949
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Country | US
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Telephone | 254-224-8808
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Fax | 254-224-6590
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATION
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Name | SAMANTHA FOSS
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Credential |
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Telephone | 254-224-8808
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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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