=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720997604
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | USA EMERGENCY CENTERS - LIBERTY HILL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/04/2026
-----------------------------------------------------
Last Update Date | 09/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10280 W STATE HIGHWAY 29
-----------------------------------------------------
City | LIBERTY HILL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78642-4815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 737-983-0911
-----------------------------------------------------
Fax | 737-983-0901
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10280 W STATE HIGHWAY 29
-----------------------------------------------------
City | LIBERTY HILL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78642-4815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 737-983-0911
-----------------------------------------------------
Fax | 737-983-0901
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP OF OPERATIONS
-----------------------------------------------------
Name | IZAAN ROOS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 512-521-1709
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QE0002X
-----------------------------------------------------
Taxonomy Name | Emergency Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------