MEDICARE: SUGAR LAND EMERGENCY ROOM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1093604662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUGAR LAND EMERGENCY ROOM LLC

Provider Business Mailing Address
First Line	:	222 HIGHWAY 6 STE 100
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4994
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 HIGHWAY 6 STE 100
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4994
Country	:	US
Telephone Number	:	228-169-7525
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	HUMAIRA QURESHI
Credential	:
Telephone Number	:	281-712-8033

Provider Enumeration Date	:	06/30/2025
Last Update Date	:	06/30/2025

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