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NPI Code Detail

MEDICARE: CEC HIGHLANDS RANCH LLC

MEDICARE: CEC HIGHLANDS RANCH 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
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1174474522
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEC HIGHLANDS RANCH LLC
Provider Business Mailing Address
First Line : 2360 DEAN WAY
Second Line :
City : SOUTHLAKE
State : TX
Zip : 76092-1379
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2680 E COUNTY LINE RD UNIT H
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80126-3235
Country : US
Telephone Number : 817-421-0034
Fax Number :
Authorized Official
Title or Position : COO
Name : JULIE RADLEY
Credential :
Telephone Number : 713-591-2256
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “CEC HIGHLANDS RANCH LLC ” Practice Location

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