=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861811507
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONCALL EMERGENCY CENTERS ,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2014
-----------------------------------------------------
Last Update Date | 09/16/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3901 BELLAIRE BLVD STE A
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77025-1100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-838-6522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3901 BELLAIRE BLVD STE A
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77025-1126
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-357-4509
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO FOUNDER, CEO & PRESIDENT
-----------------------------------------------------
Name | MR. STEPHEN G. MYERS
-----------------------------------------------------
Credential | JD, LLM, MBA
-----------------------------------------------------
Telephone | 713-357-4509
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QE0002X
-----------------------------------------------------
Taxonomy Name | Emergency Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------