MEDICARE: TEXAS EM-I MEDICAL SERVICES, PA

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	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1093987844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS EM-I MEDICAL SERVICES, PA

Provider Business Mailing Address
First Line	:	PO BOX 41781
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19101-1781
Country	:	US
Telephone Number	:	214-712-2000
Fax Number	:	214-712-2444

Provider Business Practice Location Address
First Line	:	5314 DASHWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-4603
Country	:	US
Telephone Number	:	713-512-1530
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM JERNBERG
Credential	:
Telephone Number	:	800-355-0808

Provider Enumeration Date	:	04/01/2008
Last Update Date	:	04/01/2008

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