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General NPI Number Information
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NPI Number | 1811360142
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Entity Type | Organization
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Legal Business Name | SELECT ER, LLC
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 3808 KEMP BLVD STE A
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2150
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Country | US
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Telephone | 832-367-2844
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Fax |
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Provider Business Mailing Address
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Address Line | 15611 OYSTER COVE DR
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City | SUGAR LAND
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State | TX
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Zip | 77478-3364
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Country | US
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Telephone | 832-367-2844
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL PARTNER
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Name | DR. GARY NEWMAN YEE
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Credential | MD
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Telephone | 832-367-2844
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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 | 32057311659
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License Number State | TX
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