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NPI Code Detail

MEDICARE: FRONTLINE ER

MEDICARE: FRONTLINE ER
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
1261QE0002XEmergency Care Clinic/Center

General Provider Information

NPI Number : 1245605138
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRONTLINE ER
Provider Business Mailing Address
First Line : 627 FLAGHOIST LN
Second Line :
City : HOUSTON
State : TX
Zip : 77079-2552
Country : US
Telephone Number : 281-961-3217
Fax Number :
Provider Business Practice Location Address
First Line : 7051 FM 1464 RD
Second Line :
City : RICHMOND
State : TX
Zip : 77407-9542
Country : US
Telephone Number : 281-961-3217
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : ETHAN TRAN
Credential : MD
Telephone Number : 281-961-3217
Provider Enumeration Date : 12/03/2015
Last Update Date : 12/03/2015

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Directions to “FRONTLINE ER ” Practice Location

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