MEDICARE: WACO TEXAS EMERGENCY CENTER 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	:	1205791183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WACO TEXAS EMERGENCY CENTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 3112
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77253-3112
Country	:	US
Telephone Number	:	254-317-8039
Fax Number	:	830-428-0499

Provider Business Practice Location Address
First Line	:	1411 N VALLEY MILLS DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-4460
Country	:	US
Telephone Number	:	254-317-8039
Fax Number	:	830-428-0499

Authorized Official
Title or Position	:	VICE PRESIDENT, REVENUE CYCLE
Name	:	DARLEEN CALLAHAN
Credential	:
Telephone Number	:	607-437-7902

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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